{"id":"7fb75d3dec2f","type":"article","url":"https://hartvaat.nl/2026/10/01/valve-in-valve-tavr-planning-techniek-en-levenslange-zorg-bij-gefaalde-klepproth/","title":"Valve-in-Valve TAVR: planning, techniek en levenslange zorg bij gefaalde klepprothesen","title_en":"Valve-In-Valve Transcatheter Aortic Valve Replacement: Advances in Planning, Technique, and Lifetime Management.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Interventional cardiology clinics","doi":"10.1016/j.iccl.2026.05.005","source_url":"https://doi.org/10.1016/j.iccl.2026.05.005","authors":["Anastasia Proshkina","Fares Ghanem","Ahmad Al Turk"],"significance":6,"published":"2026-09-05","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/cabg-bypasschirurgie/","https://hartvaat.nl/kennis/kleplijden/anticoagulatie-bij-klepprothese/"],"congress":"","summary_en":"This review discusses valve-in-valve TAVR as a reintervention strategy for failed surgical bioprostheses. Meticulous preprocedural planning with CT, fluoroscopy, and TEE is essential, while emerging AI tools and techniques like valve fracture can help mitigate risks such as coronary obstruction and patient-prosthesis mismatch. Given the aging population and favorable safety profile, this minimally invasive approach will continue to grow in prevalence, preparing structural heart programs for the long-term management of these patients.","created":"2026-08-29T01:15:32Z","updated":"2026-08-29T01:15:32Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze overzichtsstudie bespreekt valve-in-valve TAVR als reinterventieoptie voor gefaalde chirurgische bioprothesen. Meticuleuze preprocedurale planning met CT, fluoroscopie en TEE is essentieel, terwijl nieuwe AI-tools en technieken zoals klepfractuur risico’s zoals coronaire obstructie en patient-prosthesis mismatch kunnen beperken. Gezien de vergrijzing en het gunstige veiligheidsprofiel blijft deze minimally invasieve ingreep in populariteit groeien, wat structurele hartenklinieken voorbereidt op de langdurige begeleiding van deze patiëntengroep.","abstract_original":"Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) has emerged as a key reintervention strategy for failed surgical bioprostheses. Meticulous preprocedural planning with computed tomography, fluoroscopy, and transesophageal echocardiography is essential for optimal outcomes. Emerging artificial intelligence-based technologies may help mitigate associated risks such as coronary obstruction and patient-prosthesis mismatch and assist with lifetime management planning for valvular heart disease. Transcatheter valve underexpansion can be addressed through bioprosthetic valve fracture in select cases. ViV-TAVR is likely to continue to grow in prevalence given an aging population, its minimally invasive nature compared to redo surgical aortic valve replacement, and its favorable safety profile."}