Dr Malik will be doing a live case at an international meeting this week:
“It is a complicated situation with a previous TAVI in place and now a need for a second procedure. I am glad to be asked to join the team. Very few cases have been done in the world
The issues are:
1. Do we need to worry about the coronary arteries being covered by the new valve and blocked?
2. The old valve is oval and a rare type that is no longer used. It is a DFM TAVI- with a ceramic polymer in the rings. Can we make it circular?
3. What technology should we use? Balloon expandable or self- expanding.?
4. Should we push the valve out more after deployment- crack it or push it?
I have put the question out on social media as, having looked at the literature published, there is no right answer. It has generated a good discussion in the TAVI community. Again, no unified view, but that was what I expected, and I did it to educate others as much as myself!
I will tell you how it goes !”