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Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is an alternative approach to redo-SAVR in patients with degeneration of bioprosthetic aortic valves. However, ViV-TAVI is associated with two main technical challenges: the risk of coronary obstruction and the risk of patient prosthesis mismatch. Although it is extremely rare, coronary obstruction is a life-threatening event that occurs three-fold to four-fold more commonly after ViV-TAVI compared with native valve TAVI. We report the case of an 85-year-old patient with a degenerated bioprosthetic aortic valve treated with ViV-TAVI and double chimney technique to overcome the predicted high risk of right and left coronary obstruction.

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Difficult Cases and Complications from Catheterization Laboratory: Preventing Coronary Artery Obstruction with a Double Chimney During ViV-TAVI

  • 章节

  • 发表日期：

    2026年

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  • Edoardo Pancaldi,
  • Marianna Adamo

摘要

Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is an alternative approach to redo-SAVR in patients with degeneration of bioprosthetic aortic valves. However, ViV-TAVI is associated with two main technical challenges: the risk of coronary obstruction and the risk of patient prosthesis mismatch. Although it is extremely rare, coronary obstruction is a life-threatening event that occurs three-fold to four-fold more commonly after ViV-TAVI compared with native valve TAVI. We report the case of an 85-year-old patient with a degenerated bioprosthetic aortic valve treated with ViV-TAVI and double chimney technique to overcome the predicted high risk of right and left coronary obstruction.