Valve-in-valve apps: why and how they were developed and how to use them.

Rapid growth in transcatheter heart valve (THV) technology has led to its use in the treatment of degenerated bioprosthetic surgical heart valves (SHV) and failed mitral repairs. Multiple reports of valve-in-valve (VIV) and valve-in-ring (VIR) procedures have appeared in the literature during the last three years. The success of a VIV procedure is based on the correct identification of the surgical valve/ring, choosing the correct size of the THV and its subsequent accurate placement. There are, however, SHV and mitral rings implanted in the last two decades which differ in design, dimensions and fluoroscopic appearances. In the past, the users had to search through the literature to find out case-specific information. Unlike publications, by using the smartphone platform, we have collated vast amounts of available information, which can take the user through various links to present specific information about a clinical scenario relevant to their patient. Once downloaded, the information is available without the need for an Internet connection and can help in planning and performing a VIV/VIR procedure. The app platform also allows the addition of new material easily in the pre-existing user interface.