Minimally invasive off-pump valve-in-a-ring implantation: the atrial transcatheter approach for re-operative mitral valve replacement after failed repair

Abstract

Transatrial, transcatheter mitral VinR implantation is feasible using a minimally invasive off-pump approach. VinR implantation is a promising concept for re-operative surgery for selected patients after failed mitral valve repair.

Mitral valved stent implantation☆☆☆

“…Recurrence of significant mitral regurgitation has been reported in up to 30% of patients at 6 months [9,10]. Therefore, a less invasive approach for mitral valve surgery might be beneficial in this high-risk group of patients [11]. Trans-catheter mitral valved stent implantation has the potential to become the preferred intervention since it can theoretically achieve a reduction in mitral regurgitation similar to that of surgery and preserve the mitral apparatus at the same time.…”

New Self-Expanding Transcatheter Valve for Off-Pump Transatrial Mitral Valve-In-Ring Implantation

“…Malapposition and noncircularity might lead to leaflet malcoaptation, resulting in regurgitation and early degeneration of the device. The overall experience of VIR is mostly limited to isolated clinical case reports, small series and animal studies [10,14,[22][23][24] . Descoutures et al [10] reported preliminary multicenter results of 17 cases, and that VIR may provide short-term clinical and hemodynamic improvement.…”

Transvenous Mitral Valve Replacement After Failure of Surgical Ring Annuloplasty

“…Re-operation might carry a high risk in patients with comorbidities. A few reports have suggested the feasibility of transcatheter mitral valve replacement after failure of surgical ring annuloplasty (1)(2)(3)(4). We report here the first series of transvenous mitral valve-in-ring implantation (TVIR).…”