Transfemoral Implantation of Transcatheter Heart Valves After Deterioration of Mitral Bioprosthesis or Previous Ring Annuloplasty

Abstract

This single-center series suggests that transfemoral THV implantation for deterioration of mitral bioprosthesis or surgical repair is feasible in selected patients and improves early hemodynamic and midterm functional status.

Percutaneous Treatment Options for Recurrent Mitral Valve Disease after Failed Mitral Valve Surgery

“…Our results regarding procedural success, symptom reduction and survival are in line with the current literature (9,10,(23)(24)(25)(26)(27). Our mean follow-up survival was 76% and comparable to the published larger series, reporting survival rates of 71-90% [9,24,25].…”

“…Our mean follow-up survival was 76% and comparable to the published larger series, reporting survival rates of 71-90% [9,24,25]. The largest series most recently documented survival rates of even 93%, but the reported median follow-up in this series was only 40 days [23].…”

“…The 30 day mortality of 0% in our series was lower than the predicted survival by currents surgical scores. However, compared to other studies the patients in our study had relatively low predicted mortality scores [10,25,26]. The widely used risk scores (EuroSCORE II and STS mortality score) cover many, but not all relevant clinical risk factors.…”

“…At this time, balloon-expandable aortic Sapien XT or Sapien 3 valves (Edwards Life sciences, Irvine, California) are predominantly reported in series describing percutaneous mitral VIR or VIV replacement [9,12,23,25]. Other types of valves are either under investigation, anatomically not suitable or described only in few number of studies.…”

“…Based on the experiences of transcatheter aortic valve implantations, the initial access route for percutaneous mitral valve replacement was transapical, enabling good alignment with the ring/prosthesis in mitral position [10]. The development of third and fourth generation percutaneous valves with advanced steering capabilities of the catheter has promoted the transseptal approach in recent publications [23,25,27]. The use of the recently developed real time fusion imaging techniques like EchoNavigator (Phillips Healthcare, Amsterdam, Netherlands) further facilitates such interventions [30,31].…”