Internet Video of the Week : Valve-in-valve procedure: importance of the anatomy of surgical bioprostheses

Transcatheter aortic valve implantation has also evolved as a suitable treatment option for degenerative surgical heart valve disease, with considerable experience in the aortic and mitral positions. Success of a valve-in-valve (VIV) procedure depends on four main concepts. These include the following:

• Understanding transcatheter heart valve design.
• A detailed understanding of the design or anatomy, in particular fluoroscopic appearances of the failing SHV.
• Correct sizing of the chosen transcatheter heart valve prosthesis for the existing SHV.
• The ideal implantation position for the transcatheter heart valve.

The aim of this article is to emphasize the impact of the anatomy and design features of surgical heart valve disease (SHV) to provide an understanding of VIV procedures and ensure their success, with focus on VIV in the failing aortic SHV.