Key result
Transcatheter mitral valve-in-valve and valve-in-ring procedures are commonly successful but carry risks of device malposition, elevated gradients, LVOT obstruction, and regurgitation.
Careful patient selection and anatomical evaluation are essential for optimal outcomes in transcatheter mitral valve-in-valve and valve-in-ring procedures due to risks of malposition, elevated gradients, and LVOT obstruction.
Supports careful anatomical evaluation before mitral ViV/ViR; leaves open prospective validation of selection criteria.
There is a growing practice of transcatheter treatment of failed mitral valves after cardiac surgery, including valve-in-valve and valve-in-ring. Although commonly successful, these procedures can be associated with device malposition (including delayed malposition) and elevated post-procedural gradients (especially when performed inside small surgical valves). Valve-in-ring procedures have elevated risks of left ventricular outflow tract obstruction and post-procedural regurgitation. Careful patient selection and meticulous evaluation of patient anatomy and surgical implant characteristics are essential to achieve optimal clinical results with mitral valve-in-valve and valve-in-ring implantation.
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Dvir et al. (2016) conducted a review in Failed mitral valves after cardiac surgery. Transcatheter mitral valve-in-valve and valve-in-ring procedures was evaluated. Transcatheter mitral valve-in-valve and valve-in-ring procedures are commonly successful but carry risks of device malposition, elevated gradients, LVOT obstruction, and regurgitation.
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