Key result
A transcatheter mitral valve-in-valve-in-valve replacement with transseptal puncture was described in a patient with severe prosthetic mitral valve stenosis and an existing atrial septal occluder.
Why the study?
Closing an iatrogenic atrial septal defect with an occluder device after percutaneous transcatheter mitral valve replacement can preclude subsequent required transseptal interventions.
Case Report (n=1)
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This case demonstrates the feasibility of performing a transseptal puncture for a transcatheter mitral valve-in-valve-in-valve replacement even in the presence of a previously placed atrial septal occluder device.
Quite often the iatrogenic atrial septal defect created after percutaneous transcatheter mitral valve replacement procedures is closed with an atrial septal occluder device thus precluding further transseptal interventions if required. In this case report, we describe a patient who previously underwent a valve-in-valve transcatheter mitral valve replacement and iatrogenic atrial septal defect closure with an Amplatzer device, who developed severe prosthetic mitral valve stenosis. This patient required a second percutaneous valve-in-valve in-valve procedure with a transseptal puncture in the presence of an atrial septal occluder device.
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Qureshi et al. (2021) conducted a case report in Severe prosthetic mitral valve stenosis (n=1). Transcatheter mitral valve-in-valve-in-valve replacement with transseptal puncture was evaluated. A transcatheter mitral valve-in-valve-in-valve replacement with transseptal puncture was described in a patient with severe prosthetic mitral valve stenosis and an existing atrial septal occluder.
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