Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct;104(4):837-852.
doi: 10.1002/ccd.31166. Epub 2024 Jul 30.

Outcomes after transcatheter mitral valve implantation in valve-in-valve, valve-in-ring, and valve-in-mitral annular calcification

Hector A Alvarez-Covarrubias  1   2 , Michael Joner  1   3 , Marius Lutz  4 , Erion Xhepa  1   3 , N Patrick Mayr  5 , Mark Lachmann  6 , Salvatore Cassese  1   3 , Tobias Rheude  1 , Costanza Pellegrini  1 , Sebastian Kufner  1   3 , Heribert Schunkert  1   3 , Adnan Kastrati  1   3 , Magdalena Erlebach  4 , Rüdiger Lange  4 , Hendrik Ruge  4
Affiliations

Outcomes after transcatheter mitral valve implantation in valve-in-valve, valve-in-ring, and valve-in-mitral annular calcification

Hector A Alvarez-Covarrubias et al. Catheter Cardiovasc Interv. 2024 Oct.

Abstract

Aims: We aimed to evaluate transcatheter mitral valve implantation (TMVI) using predominantly balloon-expandable transcatheter heart valves (THV) in patients with a landing zone for a percutaneously delivered prosthesis.

Background: Patients with a degenerated mitral valve bioprosthesis, annuloplasty ring, and mitral annulus calcification (MAC) considered at high surgical risk currently represent a treatment challenge. TMVI is an alternative treatment option.

Methods: Retrospective analysis of patients with symptomatic degenerated mitral valve bioprosthesis, or annuloplasty ring, and MAC treated with TMVI between November 2011 and April 2021. Endpoints were defined according to Mitral Valve Academic Research Consortium (MVARC) criteria and included device and procedure success at 30 days as well as mortality at 30 days and 1 year after the procedure.

Results: A total of 77 patients underwent TMVI (valve in valve [ViV = 56], valve in ring [ViR = 11], and valve in MAC [ViMAC = 10]). There was a trend toward higher technical success (all = 93.5%, ViV = 96.4%, ViR = 90.9%, ViMAC = 80%, p = 0.06) and lower 30-day (all = 11.7%, ViV = 10.7%, ViR = 9.1%, ViMAC = 20%, p = 0.49) and 1-year mortality (all = 26%, ViV = 23.2%, ViR = 27.3%, ViMAC= 40%, p = 0.36) after ViV and ViR compared to ViMAC.

Conclusion: TMVI represents a reasonable treatment option in selected patients with MAC or who are poor candidates for redo mitral valve surgery. Technical success and survival up to 1 year were not significantly dependent on the subgroup in which TMVI was performed.

Keywords: transcatheter mitral valve implantation; valve‐in‐mitral annulus calcification; valve‐in‐ring; valve‐in‐valve.

PubMed Disclaimer

References

REFERENCES

    1. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021;143(5):e35‐e71.
    1. Chikwe J, Chiang YP, Egorova NN, Itagaki S, Adams DH. Survival and outcomes following bioprosthetic vs mechanical mitral valve replacement in patients aged 50 to 69 years. JAMA. 2015;313(14):1435‐1442.
    1. Kilic A, Helmers MR, Han JJ, et al. Redo mitral valve surgery following prior mitral valve repair. J Card Surg. 2018;33(12):jocs.13944.
    1. Mehaffey HJ, Hawkins RB, Schubert S, et al. Contemporary outcomes in reoperative mitral valve surgery. Heart. 2018;104(8):652‐656.
    1. Onorati F, Perrotti A, Reichart D, et al. Surgical factors and complications affecting hospital outcome in redo mitral surgery: insights from a multicentre experience. Eur J Cardiothorac Surg. 2016;49(5):e127‐e133.

MeSH terms

LinkOut - more resources