Percutaneous Implantation of CoreValve Aortic Prostheses in Patients With a Mechanical Mitral Valve

Bruschi, Giuseppe; Marco, Federico De; Oreglia, Jacopo; Colombo, Paola; Fratto, Pasquale; Lullo, Francesca; Paino, Roberto; Frigerio, Maria; Martinelli, Luigi; Klugmann, Silvio

doi:10.1016/j.athoracsur.2009.07.028

Cited by 35 publications

(33 citation statements)

References 7 publications

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“…It is difficult to recommend an optimum vascular approach and type of the artificial valve based on the limited experience to date. Some suggest the use of the self-expandable CoreValve prosthesis in this group of patients might be related to higher incidence of underexpansion or deformation of the prosthesis due to self-expanding support frame of the valve [7]. On the other hand in case of proper position of CoreValve the function of implanted valve might be better due to leaflets in supra-valvular position without important frame deformities and under-expansion.…”

Section: Discussionmentioning

confidence: 99%

“…The selection of optimal nonfemoral route should be anatomy driven. Trans-apical access may bear the risk of interference between delivery sheath and artificial mitral prosthesis [7,15]. On the other hand trans-apical approach offers the best manipulation and positioning control.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of post-procedural dysfunction of the mitral prosthesis as a consequence of its damage during percutaneous manipulation or due to functional interference with aortic bioprosthesis [5]. Nevertheless, a number of authors have published successful cases of TAVI in the presence of mechanical valve prostheses [6][7][8][9][10][11][12][13]. In this paper we present four patients who underwent successful TAVI after previous mitral valve surgery.…”

Section: Introductionmentioning

confidence: 99%

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Trans-catheter Aortic Valve Implantation in Patients with Previous Mitral Valve Replacement: A Case Series

Škafar¹,

Zbacnik²,

Ambrožič³

et al. 2017

J Clin Exp Cardiolog

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Introduction: Transcatheter aortic valve implantation is a routine clinical method for patients with severe aortic stenosis at high surgical risk, such as previous cardiac surgery. The presence of mechanical mitral prosthesis might complicate trans-catheter aortic valve implantation because of possible interference between both prostheses. Some clinical reports have already demonstrated the feasibility of trans-catheter aortic valve implantation in such patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Trans-catheter Aortic Valve Implantation in Patients with Previous Mitral Valve Replacement: A Case Series

Škafar¹,

Zbacnik²,

Ambrožič³

et al. 2017

J Clin Exp Cardiolog

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“…Therefore the presence of mitral valve prosthesis is considered a contraindication for TAVI in the currently ongoing Placement of AoRTic TraNscathetER Valve (PARTNER) Trial, which compares TAVI, surgical aortic valve replacement and medical therapy [2]. In spite of this, some case reports have emerged in the last years showing the feasibility of TAVI via transfemoral as well as transapical approach with both available percutaneous aortic prostheses (Edwards Sapien, Edwards Lifesciences, Inc., Irvine, California and CorveValve, Inc., Irvine, California) in patients with artificial mitral valve [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…TAVI in a patient with pre-existent mechanical mitral valve should be considered with caution due to anatomical close proximity of the aortic and mitral annuli [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Successful Tavi in Patients with Previous Mitral Valve Replacement

Bunc¹,

Ambrožič²,

Mušič³

et al. 2012

IJCM

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Background: Transcatheter aortic valve implantation (TAVI) is a new method for patients with severe aortic stenosis at high surgical risk, such as previous cardiac surgery. The presence of mechanical mitral prosthesis might complicate TAVI because of possible interference between both prostheses. Some reports have already demonstrated the feasibility of TAVI in such patients. Case Reports: We report 2 patients with severe symptomatic aortic stenosis who had prior mitral valve replacement that successfully underwent TAVI with Edwards Sapien and CoreValve aortic prosthesis, respectively. Computed tomographic angiography (CTA) was useful for the assessment of the distance between both aortic and mitral prosthesis annuli. Transesophageal echocardiography was crucial for precise positioning of TAV. There were no special technical tips besides precise positioning of the valve prosthesis. In case of Core Valve the goal was the positioning at "zero point" and in case of Edwards Sapien valve a "half-on-half" position according to natural aortic valve. We observed no deformation or dysfunction of aortic and mitral prosthesis in any of the patients. Balloon valvuloplasty prior to implantation helps to observe the mutual effect of the new aortic valve and pre-existent mitral prosthesis. Conclusions: We conclude that TAVI can be safely and successfully performed in patients with mechanical mitral prosthesis carefully considering the altered anatomical conditions. Skillfulness and TAVI experience of the operators should not be neglected.

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