Valve in Valve surgery higher endocarditis?

[Gail in Ca]

Had anyone read anything about the catheter method of placing a valve inside one's own deteriorating valve, or inside an already replaced tissue valve creating more stuff in there for bacteria to attach to? I was wondering about this, since my surgeon was pleased to do the valve inside a graft, therefore having the stitches on the outside, so less for a bacteria to attach itself to. As more people start getting this type of replacement, won't it create more problems with endocarditis? Are they even concerned about this, I wonder? Are these valves the type that go in collapsed and then expand once in place, like a stent for a clogged artery? Just curious, so I thought I'd post.

 

[Lynlw]

Had anyone read anything about the catheter method of placing a valve inside one's own deteriorating valve, or inside an already replaced tissue valve creating more stuff in there for bacteria to attach to? I was wondering about this, since my surgeon was pleased to do the valve inside a graft, therefore having the stitches on the outside, so less for a bacteria to attach itself to. As more people start getting this type of replacement, won't it create more problems with endocarditis? Are they even concerned about this, I wonder? Are these valves the type that go in collapsed and then expand once in place, like a stent for a clogged artery? Just curious, so I thought I'd post.

I have not heard of any increased rates of BE for valves in valves, either in the newer Aortic ones or in the Pulmonary valves they've been doing about 15 years now. I looked and most articles seem to say it is "rare" I dont know how that compares to sewn in valves.
I knw the post op infection rates are lower since there isnt a large or several small incisions.
Yes they are crimped inside a stent frame and expand into place, much like other stents. They are doing newer things, like the Sapien they (the doctor) expand and Corevalve is self expanding. Something I found interesting is , they don't have didferent TAVI valves for each size valve, 1 size goes in a small range of old tissue valves since it opens to fit inside it.

The Newer TAVI valves they are working on, are also repositionable, so if they don't like exactly how it is seated, they can close it and reopen it. Some things i've seen say it is easier to place a percutaneous valve in an old tissue valve than a native valve, since they know the exact size in the person and it is usually a better circle. for lack of a better word right now.

There are quite a few videos and webcasts on them it is pretty interesting, I can find some if you want

 

[Jkm7]

What a great post, Lyn.
Really interesting.
Thanks for it.