Emergency transapical mitral valve-in-valve implantation for bioprosthesis failure: transapical implantation of an Edwards Sapien-XT in a dysfunctional mitral bioprosthesis in a critical patient

J Cardiothorac Surg. 2017 Dec 13;12(1):114. doi: 10.1186/s13019-017-0680-7.

Abstract

Background: Valve-in-Valve (VIV) Transcatheter Aortic Valve Replacement (TAVR) is now the treatment of choice in high-surgical-risk patients with failing aortic bioprosthesis. Although less performed, VIV-Transcatheter Mitral Valve Replacement (TMVR) is a valid treatment option for selected high-risk patients with degenerated mitral bioprostheses. Several cases of elective ViV- TAVR and -TMVR have been reported but only few were performed in critical hemodynamic conditions.

Case presentation: We report the case of a patient underwent balloon-expandable transapical mitral valve-in-valve implantation in an emergency setting due to a severe stenosis of a bioprosthesis in mitral position. The procedure was successfully performed, with no residual mitral regurgitation or paravalvular leaks, and uneventful.

Conclusion: Transcatheter transapical mitral valve-in-valve implantation could represent a feasible and effective strategy even in critical setting.

Keywords: Bioprosthesis; Emergency; Mitral bioprosthesis; Mitral valve stenosis; Transapical; Transcatheter valve implantation; Valve-in-valve.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Bioprosthesis / adverse effects*
  • Critical Illness
  • Emergencies
  • Female
  • Heart Valve Prosthesis
  • Humans
  • Mitral Valve / surgery*
  • Prosthesis Failure*
  • Transcatheter Aortic Valve Replacement / instrumentation
  • Transcatheter Aortic Valve Replacement / methods*
  • Treatment Outcome