ViV Aortic

What this clinical reference covers

ViV Aortic is a reference for cardiologists and cardiac surgeons who are planning or carrying out a valve-in-valve procedure. A valve-in-valve case places a TAVR valve inside a previously implanted surgical valve, so the clinician needs to know the design of the surgical valve, the right TAVR size for it, and where the new valve should sit. The app is built around those three questions.

According to the listing, the app began as a collaboration between the technology company UBQO and Dr Vinayak Bapat, a consultant cardiac surgeon at St Thomas' Hospital in London. KRUTSCH is named as the developer that redesigned it, adding a new interface and a way for cardiologists to edit valve data stored in the cloud.

The listing frames the app as a way to avoid searching through a large body of literature for each case. Its content is organised by clinical scenario, so a user works through the particular valve and situation in front of them rather than reading general material.

Looking up surgical valve designs and sizes

The app holds design information for several types of surgical valve, along with the sizing information for each. The listing points out that surgical valves look different under fluoroscopy and differ in internal diameter, which is why both the appearance and the size matter when a clinician is judging whether a valve can take a TAVR valve.

Alongside the written data are real-life and fluoroscopic images of the surgical valves. A clinician can compare what a valve looks like on the screen in the cath lab with a photograph of the valve itself, which is the comparison the listing presents as the basis for correct identification.

Choosing a TAVR valve and its size

For TAVR valves, the app gives design information on each valve design, and sizing information for the sizes available. The listing says that TAVR valves differ both in appearance and in the sizes they come in, so the sizing data is set out per design.

The app takes the user through the selection in a fixed order. First the surgical valve is chosen, then the TAVR size that could be used with it, and finally the dimensions that matter for planning the procedure. The listing describes this as stepping through the possible combinations so that the user reaches the information for their specific case.

Identifying a surgical valve of unknown type

Sometimes the surgical valve in a patient is not known. The listing says the app then leads the user through a series of steps to identify the valve type, and once the type is identified, the same design and sizing information for that valve becomes available.

This matters because the listing notes that knowledge of surgical valves implanted over the last two decades is limited, though relevant to valve-in-valve therapy. The identification steps are the route the app offers for a valve the clinician cannot name from the record.

Placement guidance, video and design detail

The app includes image-based guidance on where a TAVR valve should be placed ideally. It also has video showing real placement of a TAVR valve, so the written steps can be seen in action.

A further section discusses the design considerations behind the procedure in more depth. The listing presents this as background for understanding the valve-in-valve procedure as a whole, rather than a set of instructions for a single case.

Offline use and editing valve data

The listing states that the information can be used without an internet connection. That makes the reference available in settings where the network is unreliable, such as a theatre or a cath lab with restricted access.

The developer also describes an editing interface that lets cardiologists change valve data held in the cloud. The listing does not say how that editing is reviewed or who can make changes, so those details are not covered here.