Valve-in-valve procedures are likely to become increasingly frequent with the aging of the population and the increasing number of surgical bioprostheses implanted. More than 50% of these implanted valves have small diameters, which hinders the good expansion of transcatheter devices, leading to higher final gradients. Therefore, post-dilation is required to optimize implantation of the new device. Compliant balloons have limitations and a higher potential to rupture when used for this purpose. We describe a case of a valve-in-valve procedure using a non-compliant balloon for post-dilation of the implanted transcatheter device in a bioprosthesis with a small ring.
Post-dilation with non-compliant balloon for optimization of outcomes after implantation of self-expandable transcatheter bioprosthesis
Esteves,Vinicius Borges Cardozo and Andrade,Pedro Beraldo de and Rinaldi,Fábio Salerno and Tiveron,Marcos and Tebet,Marden André and Mattos,Luiz Alberto Piva e. Post-dilation with non-compliant balloon for optimization of outcomes after implantation of self-expandable transcatheter bioprosthesis. J Transcat Intervent. [online]. 2019, vol.27, [cited 2026-03-06], Available from: <https://jotci.org/article/post-dilation-with-non-compliant-balloon-for-optimization-of-outcomes-after-implantation-of-self-expandable-transcatheter-bioprosthesis/>. ISSN . http://doi.org/10.31160/JOTCI201927A20180007.
Esteves,Vinicius Borges Cardozo; Andrade,Pedro Beraldo de; Rinaldi,Fábio Salerno; Tiveron,Marcos; Tebet,Marden André; Mattos,Luiz Alberto Piva e. Post-dilation with non-compliant balloon for optimization of outcomes after implantation of self-expandable transcatheter bioprosthesis. J Transcat Intervent., v.27, May. 2019. Available from: <https://jotci.org/article/post-dilation-with-non-compliant-balloon-for-optimization-of-outcomes-after-implantation-of-self-expandable-transcatheter-bioprosthesis/>. acess on 06 Mar. 2026. http://doi.org/10.31160/JOTCI201927A20180007.
Esteves,Vinicius Borges Cardozo, & Andrade,Pedro Beraldo de, & Rinaldi,Fábio Salerno, & Tiveron,Marcos, & Tebet,Marden André, & Mattos,Luiz Alberto Piva e. (2019). Post-dilation with non-compliant balloon for optimization of outcomes after implantation of self-expandable transcatheter bioprosthesis. J Transcat Intervent., 27, http://doi.org/10.31160/JOTCI201927A20180007.
EstevesVinicius Borges Cardozo, AndradePedro Beraldo de, RinaldiFábio Salerno, TiveronMarcos, TebetMarden André, MattosLuiz Alberto Piva e. Post-dilation with non-compliant balloon for optimization of outcomes after implantation of self-expandable transcatheter bioprosthesis. J Transcat Intervent. [Internet]. 2019 May [cited 2026 Mar 06]; 27: Available from: https://jotci.org/article/post-dilation-with-non-compliant-balloon-for-optimization-of-outcomes-after-implantation-of-self-expandable-transcatheter-bioprosthesis/. http://doi.org/10.31160/JOTCI201927A20180007.
Figure 4
Aortic transvalvular gradient. (A) Echocardiographic control showing gradient after implantation of the transcatheter prosthesis; (B) major drop in gradient after balloon dilation.
