Image in Cardiology
Transcatheter mitral valve-in-valve implantation: Role of preprocedural multidetector computed tomography
Implantação mitral transcateter valve-in-valve: papel pré-procedimento da tomografia computadorizada com multidetetores
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A possible alternative for patients at high surgical risk is transcatheter implantation of a prosthesis in reverse position using the valve-in-valve technique.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Based on our experience with three cases of transcatheter double valve (aortic and mitral) implantation by a transapical approach, we describe the essential steps in preprocedural planning using multidetector computed tomography (MDCT). The first step is to identify the brand and size of the previously implanted bioprosthesis. The true internal diameter of this valve is then determined by MDCT (mean of major and minor axes, <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>), which is usually less than the labeled prosthesis size. The true internal diameter should be confirmed by referring to conversion tables or software apps such as ViV<span class="elsevierStyleSup">®</span> (Valve-In-Valve). The internal diameter between the stent posts of the bioprosthesis is then measured (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>), since if this is less than the true internal diameter due to deformation of the stent posts, it can prevent transcatheter valve-in-valve implantation. This information is then used to select the correct size of the valve to be implanted and the procedure can commence.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">MDCT plays an essential role in planning transcatheter mitral valve implantation, to determine the true internal diameter of the dysfunctional bioprosthesis, select the correct size of the replacement valve and prevent periprocedural complications such as the valve becoming wedged against the stent posts, paravalvular leak or valve migration.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0180" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-04-21" "fechaAceptado" => "2014-05-04" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Galvão Braga C, Carvalho M, Ferreira N, Bettencourt N, Gama V. Implantação mitral transcateter <span class="elsevierStyleItalic">valve-in-valve</span>: papel pré-procedimento da tomografia computadorizada com multidetetores. Rev Port Cardiol. 2014;33:745–746.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1542 "Ancho" => 1658 "Tamanyo" => 239054 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determination of the true internal diameter of a 27-mm Hancock II tissue valve (true diameter=(18.7 mm+23.1 mm)/2=21 mm).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1543 "Ancho" => 1660 "Tamanyo" => 256940 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Measurement of the internal diameter between the stent posts (arrows) of the previously implanted mitral bioprosthesis.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003300000011/v1_201412120159/S2174204914002517/v1_201412120159/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003300000011/v1_201412120159/S2174204914002517/v1_201412120159/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204914002517?idApp=UINPBA00004E" ]
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| 2017 October | 31 | 8 | 39 |
| 2017 September | 39 | 12 | 51 |
| 2017 August | 36 | 15 | 51 |
| 2017 July | 24 | 10 | 34 |
| 2017 June | 40 | 10 | 50 |
| 2017 May | 44 | 13 | 57 |
| 2017 April | 23 | 4 | 27 |
| 2017 March | 41 | 13 | 54 |
| 2017 February | 35 | 5 | 40 |
| 2017 January | 33 | 5 | 38 |
| 2016 December | 34 | 10 | 44 |
| 2016 November | 19 | 7 | 26 |
| 2016 October | 31 | 9 | 40 |
| 2016 September | 18 | 5 | 23 |
| 2016 August | 3 | 4 | 7 |
| 2016 July | 9 | 2 | 11 |
| 2016 June | 11 | 3 | 14 |
| 2016 May | 12 | 5 | 17 |
| 2016 April | 25 | 1 | 26 |
| 2016 March | 36 | 12 | 48 |
| 2016 February | 44 | 19 | 63 |
| 2016 January | 44 | 14 | 58 |
| 2015 December | 24 | 7 | 31 |
| 2015 November | 32 | 7 | 39 |
| 2015 October | 31 | 8 | 39 |
| 2015 September | 43 | 11 | 54 |
| 2015 August | 32 | 12 | 44 |
| 2015 July | 33 | 14 | 47 |
| 2015 June | 13 | 1 | 14 |
| 2015 May | 35 | 10 | 45 |
| 2015 April | 28 | 16 | 44 |
| 2015 March | 22 | 12 | 34 |
| 2015 February | 26 | 12 | 38 |
| 2015 January | 45 | 22 | 67 |
| 2014 December | 22 | 7 | 29 |
Show all
