TCT: SAPIEN XT TAVR system gains valve-in-valve indication

Transcatheter aortic valve replacement is on track to be the preferred treatment for aortic valve-in-valve replacement. How many surgeons are eager to do a reoperation on an aortic valve?

Dr. David L. Brown

Transcatheter valve replacement is the best way to treat aortic valve-in-valve disease. The results reported by Dr. Dvir further support that notion. One attraction of the balloon-expandable TAVR valve is that it greatly reduces the risk of annular rupture. But it is important to use a TAVR valve that is right sized. If the existing bioprosthesis is narrow then you have no choice but to use a self-expanding valve.

We had already been placing the SAPIEN XT, as well as SAPIEN 3 valves before XT received the valve-in-valve indication. In the past, when we did this we were never sure if the procedure would receive insurance coverage, but now XT should be covered because of the FDA approval, so this is a huge deal for us. It eliminates our economic uncertainty.

Dr. David L. Brown is director of interventional cardiology at the Heart Hospital Baylor Plano, Texas. He had no disclosures. He made these comments as a discussant at the meeting and in an interview.