Project description:Key clinical messageTranscatheter mitral valve implantation (TMVI) is considered a less-invasive approach than open-heart surgery, favored in high-risk patients elected for valve replacement. Although seemingly suitable, this procedure is highly operator-dependent.AbstractTranscatheter mitral valve implantation (TMVI) is an alternative in high-risk patients. We reported a 72-year-old patient with mitral bioprosthesis degeneration successfully receiving TMVI. The procedure has lower morbidity and mortality rate than the surgical approach but can be accompanied by several complications, especially when conducted by an inexperienced operator.

| S-EPMC10825811 | biostudies-literature

Transseptal mitral valve-in-valve replacement of intra-atrial mitral prosthesis in a patient with severe mitral annular calcification.

Project description: Not available

| S-EPMC8690276 | biostudies-literature

Transseptal mitral valve-in-valve implantation in a degenerated mitral bioprosthesis: A case report and literature review.

Project description:Transseptal TMViV should be considered for mitral bioprosthesis failure especially when large THV can be implanted. Elevated residual mean gradient and its effect on valve durability and potential valve thrombosis remains an unanswered question.

| S-EPMC8223684 | biostudies-literature

Percutaneous transseptal transcatheter mitral valve-in-valve replacement for degenerated mitral bioprosthesis: The first experience in Japan.

Project description:A 76-year-old woman had received surgical mitral valve replacement with Magna Mitral Ease (Edwards Lifesciences, Irvine, CA, USA) 25 mm for functional severe mitral regurgitation 6 years previously. She presented recurrence of heart failure due to severe stenotic and moderate regurgitant degeneration of the implanted mitral bioprosthesis. Considering her comorbidities and left ventricular systolic dysfunction, our heart valve team eventually decided to perform percutaneous transseptal transcatheter mitral valve-in-valve replacement instead of surgical redo mitral valve replacement, using a 26 mm SAPIEN 3 valve (Edwards Lifesciences) via trans-femoral approach. Post-procedural course was uneventful and she was discharged on post-procedural day 2. This is, to the best of our knowledge, the first case of successful percutaneous transseptal transcatheter mitral valve-in-valve replacement in Japan. Further large-scale prospective studies are warranted to validate its long-term safety and efficacy, particularly by comparing with the redo surgery. <Learning objective: We experienced an off-label transseptal mitral valve-in-valve replacement using SAPIEN 3 to treat degenerative mitral bioprosthesis for the first time in Japan. Although further large-scale prospective studies are warranted, this procedure should be a promising therapeutic alternative to conventional redo-surgery, particularly for elderly patients with multiple comorbidities.>.

| S-EPMC7783651 | biostudies-literature

Outcomes following transcatheter transseptal versus transapical mitral valve-in-valve and valve-in-ring procedures.

Project description:Introduction: Transcatheter mitral valve-in-valve (ViV) & valve-in-ring (ViR) are relatively novel therapeutic alternatives for patients with degenerated bioprostheses or failed annuloplasty rings whose reoperative risk is too high. The predominant procedural access for both procedures is transapical or transseptal. However, whether there are differences in outcomes of this procedure using transseptal versus transapical access has not yet been defined. Methods: We conducted a systematic review of all published articles from MEDLINE and EMBASE to explore the outcomes of these two procedural approaches. Results:total of 55 studies including 183 patients (154 ViV and 29 ViR) were included. Patients that underwent ViV (101 transapical and 53 transseptal) using the transseptal approach required more iatrogenic atrial septal defect (ASD) closure (19% versus 0.0 %; P < 0.001) and hence had a lower device success rate (68% versus 89%; P = 0.001). However, there was no significant difference between the two groups in procedural success and all-cause mortality at 30 days. Overall severe bleeding complications (major or life threatening) were not different the two groups (3.7% versus 7.9%; P = 0.321). In the ViR group (19 transapical and 10 transseptal), no difference in procedural success, device success or 30-day outcomes were identified between transseptal and transapical groups, although sample size was small. Conclusion: In conclusion, mitral ViV and ViR using the two different procedural approaches appear to confer equal and reasonable 30-day outcomes.

| S-EPMC6335986 | biostudies-literature

International LAMPOON: first European experience with laceration of the anterior mitral valve leaflet prior to transseptal transcatheter mitral valve implantation.

Project description: Not available

| S-EPMC6531677 | biostudies-literature

Preoperative planning using virtual reality for percutaneous transseptal valve-in-valve transcatheter mitral valve replacement: a case report.

Project description:BackgroundVirtual reality (VR) technology has been implemented as a pre-procedural planning tool for cardiovascular interventions to enable detailed evaluation of patient anatomy from different vantage points. Here, we employed a VR platform to preoperatively plan for percutaneous valve-in-valve transcatheter mitral replacement (ViV-TMVR) in a prohibitive surgical candidate.Case summaryAn 85-year-old male with a history of two prior sternotomies for bioprosthetic aortic valve (AV) and mitral valve (MV) 31 mm Medtronic Mosaic bioprosthesis presented with severe mitral regurgitation from a degenerative bioprosthetic MV. The patient was deemed a prohibitive surgical candidate for a third sternotomy and instead was recommended a percutaneous transseptal ViV-TMVR. An electrocardiogram-gated chest computed tomography (CT) provided a neo-left-ventricular outflow tract (neo-LVOT) of 1.89 cm2. This CT was reconstructed to create a 360° VR (360VR) model. A 29 mm SAPIEN three bioprosthetic valve, selected based on the already implanted MV, was placed inside the bioprosthetic MV and analysed in VR at different angles to ensure it would not obstruct the LVOT. The neo-LVOT measured in VR was 3.02 cm2, which would allow for sufficient blood flow without significant obstruction from the new SAPIEN three bioprosthetic valve. The patient tolerated the procedure well.DiscussionThis case demonstrates the utility of VR as a pre-procedural planning tool for interventional cardiology procedures. Preoperative planning in VR alleviated concerns regarding obstruction of the neo-LVOT and helped confirm safe implantation by clearly showing the three-dimensional spatial relationship between the implants and surrounding patient anatomy.

| S-EPMC9585901 | biostudies-literature

Transseptal, Transcatheter Mitral Valve-In-Valve Replacement: Ready for Prime Time Treatment of Bioprosthetic Valve Failure in Brazil?

Project description: Not available

| S-EPMC9363078 | biostudies-literature