Experimental transcatheter mitral valve replacement using the Edwards SAPIEN S3 valve in 1 89-year-old female with severe mitral stenosis and MAC resulted in acute hemolytic anemia.
Case Report (n=1)
TMVR in patients with severe mitral annular calcification remains high-risk and can be complicated by acute hemolytic anemia, underscoring the need for meticulous patient selection and continued device innovation.
Mitral valve disease, particularly in the context of extensive mitral annular calcification (MAC), poses significant challenges for traditional surgical management. Transcatheter mitral valve replacement (TMVR) has emerged as a promising alternative for high-risk and inoperable patients, driven by rapid advancements in valve technology, imaging techniques, and procedural strategies. Nevertheless, complications such as paravalvular leak (PVL), left ventricular outflow tract (LVOT) obstruction, and hemolysis remain obstacles to optimal outcomes, particularly in patients with complex annular anatomy. We present the case of an 89-year-old female with severe mitral stenosis and MAC who developed acute hemolytic anemia following experimental TMVR using the Edwards SAPIEN S3 valve. This case serves as a platform to explore recent advances in TMVR, including novel device platforms, enhanced imaging modalities for pre-procedural planning, innovative deployment strategies, and emerging adjunctive techniques aimed at reducing complications. Through this case, we underscore persistent challenges and emphasize the importance of meticulous patient selection and vigilant follow-up. Despite substantial progress, TMVR in the setting of MAC remains high-risk, demanding continued innovation in valve design, refined patient stratification, and improved peri-procedural management to enhance outcomes and mitigate risks such as hemolysis.
Fongrat et al. (Tue,) conducted a case report in Severe mitral stenosis and mitral annular calcification (n=1). Transcatheter mitral valve replacement (TMVR) using Edwards SAPIEN S3 valve was evaluated on Acute hemolytic anemia. Experimental transcatheter mitral valve replacement using the Edwards SAPIEN S3 valve in 1 89-year-old female with severe mitral stenosis and MAC resulted in acute hemolytic anemia.