The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Transapical Transcatheter Mitral Valve Implantation in Patients with Prior Aortic Valve Replacement: a feasibility report

DOI: 10.4244/EIJ-D-19-00947

1. University Hospital of Zurich, University of Zurich, Switzerland, Switzerland
2. Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA
3. Department of Cardiothoracic Surgery, Oslo University, Oslo, Norway
4. Clinic Pasteur, Toulouse, France
5. University Heart Center, Hamburg, Germany
6. Cardiovascular Surgery Department, Cœur Poumon CHU de Lille, Lille, France
7. Heart Center Bonn, University Hospital, Bonn, Germany
8. Emory Structural Heart and Valve Center, Atlanta, Georgia, USA
9. University Hospital of Zurich, University of Zurich, Switzerland. Cardiance Clinic, Pfäffikon, Switzerland. University of Bern, Switzerland
Disclaimer:

As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention and external reviewers - has been published immediately upon acceptance as it was received in the last round of revision. The content of this article is the responsibility of the authors.

Please note that supplementary movies are not available online at this stage. Once a paper is published in its edited and formatted form, it will be accompanied online by any supplementary movies.

To read the full content of this article, please log in to download the PDF.

Transcatheter mitral valve implantation (TMVI) has recently emerged as a treatment option for selected high-risk patients with symptomatic mitral regurgitation (MR). Although feasibility of TMVI in patients with previous aortic valve (AV) prostheses has ben reported1, the interaction between a TMVI and AV prosthesis has not previously been well-characterized. In particular, the risk of LVOT obstruction after TMVI may be higher in patients with a preexisting aortic valve prosthesis, due to the presence of concomitant left ventricular (LV) hypertrophy. Moreover, the frame of the aortic prosthesis can extend into the LVOT and the anchoring mechanism of TMVI may interfere with the normal functioning of an aortic prosthesis. Consequently, the presence of an aortic prosthesis has been considered a relative contraindication to TMVI in these patients and represented an exclusion criterion in most of TMVI early feasibility trials.
The Tendyne™ mitral valve system (Abbott Structural, Santa Clara, California) is a fully retrievable and repositionable TMVI system, which consists of a circular inner frame with porcine pericardial leaflets mounted on a self-expanding outer frame and is anchored via tether to an epicardial pad through apical access

Sign in to read and download the full article

Forgot your password?
No account yet? Sign up for free!
Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Read next article
Multistage Strategy With Perfusion SPECT and CT Pulmonary Angiogram in Balloon Pulmonary Angioplasty for Totally Occluded Lesions in CTEPH