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March 1, 2020Circulation Cardiovascular InterventionsOpen Access

Thirty-Day Outcomes of Transcatheter Mitral Valve Replacement for Degenerated Mitral Bioprostheses (Valve-in-Valve), Failed Surgical Rings (Valve-in-Ring), and Native Valve With Severe Mitral Annular Calcification (Valve-in-Mitral Annular Calcification) in the United States

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Why the study?

A comprehensive analysis of short-term outcomes for transcatheter mitral valve replacement in degenerated mitral bioprostheses, failed annuloplasty rings, and severe mitral annular calcification has not been performed.

Does transcatheter mitral valve replacement using aortic transcatheter heart valves provide favorable 30-day outcomes in poor surgical candidates with degenerated mitral bioprostheses, failed surgical rings, or severe mitral annular calcification?

Population

Patients with degenerated mitral bioprostheses, failed surgical repairs with annuloplasty rings, or severe mitral annular calcification

Comparison

MViV vs MViR vs ViMAC

Design

Retrospective registry analysis

Follow-up

30 days

Authors

MGMayra GuerreroSVSreekanth VemulapalliQXQun Xiang

Discussion

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Member takes

Overview

Supports MViV preference in high-risk patients; hypothesis-generating and requires randomized confirmation before practice change.

Structured PICO

Does transcatheter mitral valve replacement using aortic transcatheter heart valves provide favorable 30-day outcomes in poor surgical candidates with degenerated mitral bioprostheses, failed surgical rings, or severe mitral annular calcification?

P
Population
Patients with degenerated mitral bioprostheses, failed surgical repairs with annuloplasty rings or severe mitral annular calcification who are poor surgical candidates in the United States.
I
Intervention
Transcatheter mitral valve replacement using aortic balloon-expandable transcatheter heart valves (mitral valve-in-valve [MViV], mitral valve-in-ring [MViR], and valve-in-mitral annular calcification [ViMAC])
C
Comparator
Comparison between MViV, MViR, and ViMAC groups
O
Outcome
30-day outcomes including mortality, complications, valve performance (mitral valve gradient, mitral regurgitation grade), and symptoms (NYHA class)hard clinical

Transcatheter mitral valve replacement using aortic transcatheter heart valves shows favorable 30-day outcomes and symptom improvement, with valve-in-valve procedures demonstrating superior results compared to valve-in-ring and valve-in-MAC.

Cite This Study

Guerrero et al. (2020) studied this question.

synapsesocial.com/papers/69f2cb96be8e9f1f31c579e0https://doi.org/10.1161/circinterventions.119.008425
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