TY - JOUR T1 - Use of Patient-Specific 3-Dimensional Printed Models for Planning a Valve-in-Valve Transcatheter Aortic Valve Replacement and Educating Health Personnel, Patients, and Families JF - Ochsner Journal JO - Ochsner J DO - 10.31486/toj.19.0106 AU - Jose D. Tafur Soto AU - Silvia Patricia Gironza Betancourt Y1 - 2020/12/21 UR - http://www.ochsnerjournal.org/content/early/2020/10/12/toj.19.0106.abstract N2 - Background: Aortic stenosis is a common disease of the elderly. Valve replacement with open surgery is the preferred therapy for many patients with low surgical risk. Bioprosthetic valve failure occurs in up to 66% of patients and has a worse prognosis when the mechanism of failure is stenosis compared to regurgitation.Case Report: An 80-year-old female with a medical history of surgical aortic valve replacement, diabetes, chronic back pain, coronary artery disease, and hypertension was referred to the interventional cardiology clinic for heart failure symptoms. A bioprosthetic valve placement that was small for the patient's size (effective orifice area/body surface area 0.75 cm2/m2) resulted in symptomatic improvement that lasted for 7 years. The patient underwent an aortic valve-in-valve transcatheter valve replacement with excellent outcomes. Preoperative planning involved a patient-specific 3-dimensional printed patient model.Conclusion: In patients at high surgical risk, transcatheter aortic valve replacement is a fundamental pillar of treatment. However, valve-in-valve procedures have specific anatomic challenges, such as the risk of coronary artery obstruction and the limitation of valve expansion inside a rigid bioprosthetic valve frame. In those difficult cases, interventional cardiologists must make precise decisions regarding the approach. Three-dimensional models can be printed with the patient's specific measurements. This approach represents truly personalized medicine and can serve as a tool for procedural planning, education of the health personnel involved in the case, and patient and family engagement. ER -