Key result
Transcatheter valve-in-valve implantation using a SAPIEN-XT valve was successfully achieved via transjugular, transfemoral, and transapical approaches in 3 patients with no adverse events at 6 months.
Why the study?
Is transcatheter valve-in-valve implantation via transjugular/transseptal, transfemoral/transseptal, or transapical approach feasible and safe in high-risk patients with degenerated mitral biological prostheses?
Case Report (n=3)
Is transcatheter valve-in-valve implantation via transjugular/transseptal, transfemoral/transseptal, or transapical approach feasible and safe in high-risk patients with degenerated mitral biological prostheses?
Transcatheter valve-in-valve implantation for degenerated mitral prostheses is feasible via transjugular/transseptal, transfemoral/transseptal, and transapical approaches.
Supports multiple-access mitral valve-in-valve feasibility in high-risk cases; hypothesis-generating, should not yet change practice.
OBJECTIVES: There is an ongoing discussion if valve-in-valve implantations into failing mitral xenografts should be performed only via a transapical approach. BACKGROUND: In selected high-risk patients, transcatheter valve implantation is an emerging therapy for degenerated mitral xenografts in need of repeated valve replacement. METHODS: Here we describe three different strategies to treat a failing mitral biological prosthesis (Carpentier Edwards S.A.V) by implantation of a SAPIEN-XT valve, which was performed in three different patients. As access site, a transjugular/transseptal approach, a transfemoral/transseptal approach, and a transapical approach were chosen. RESULTS: With all three approaches, valve-in-valve implantation was successfully achieved. The acute hemodynamic effects were excellent and according to VARC there was no adverse event recorded during a 6 months follow-up. CONCLUSIONS: Feasibility of all three approaches is demonstrated and might be taken into consideration for treatment in various patients.
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Schäfer et al. (2012) conducted a case report in Degenerated mitral xenografts (n=3). Transcatheter valve-in-valve implantation (SAPIEN-XT) via transjugular/transseptal, transfemoral/transseptal, or transapical approach was evaluated on Procedural success and adverse events according to VARC. Transcatheter valve-in-valve implantation using a SAPIEN-XT valve was successfully achieved via transjugular, transfemoral, and transapical approaches in 3 patients with no adverse events at 6 months.
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