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Eur J Cardiothorac Surg 2000;18:453-457
© 2000 Elsevier Science NL

Mid-term results of the valve-on-valve technique for bioprosthetic failure

^a Departement of Cardiac Surgery, Medical School, University Federico II, Via S. Pansini 5, 80131 Naples, Italy
^b Departement of Cardiology, Medical School, University Federico II, Via S. Pansini 5, 80131 Naples, Italy

Received 17 January 2000; received in revised form 25 May 2000; accepted 31 May 2000.

Corresponding author. Via Bramante 17, 81100 Caserta, Italy. Tel.: +39-823-444102
e-mail: pstassa{at}tin.it

Objective: Redo operations for bioprosthesis malfunction can sometimes be technically very demanding and cardiac structures may be damaged. Excising only the leaflets of the damaged bioprosthesis and leaving the old ring in situ on which the ‘new’ mechanical valve is sutured can, in very selected cases, represent a solution. Methods: Twenty-two patients were operated on, with the valve-on-valve technique, from September 1991 through December 1992. There were three operative deaths. Results: The surviving 19 patients were followed-up from 83 to 98 months (mean 90.5 months.). There were two late deaths. The patients were examined clinically and with transthoracic and transesophageal echocardiograms. All patients were in good condition and the echocardiographic examinations showed no clinically important gradients across the prostheses. Conclusions: The valve-on-valve technique, in certain difficult situations, can give successful mid-term results.

Key Words: Bioprosthesis malfunction • Mitral and aortic valve replacement • Mechanical valves

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