Valve-in-valve transcatheter mitral valve replacement for the treatment of degenerated mitral bioprostheses: a case report_West China Medical Journal

Authors：

YAN Mengyun , FENG Yuan , CHEN Fei , ZHU Zhongkai ,  ZHAO Zhengang ,  CHEN Mao

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHAO Zhengang, Email: zhaozhengang@foxmail.com; CHEN Mao, Email: hmaochen@vip.sina.com

Keywords：

Mitral valve replacement; bioprosthetic valve failure; transcatheter; transseptal; valve-in-valve

DOI：

10.7507/1002-0179.202309200

Video：

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Surgical bioprosthetic valve in the mitral position typically degenerates in 10-15 years, when intervention is required again. In the past, redo surgical mitral valve replacement has been the only treatment choice for such patients suffering from bioprosthetic valve failure, despite the even higher risk associated with redo open-heart surgery. In recent years, transcatheter valve-in-valve implantation in the mitral position has evolved as an reasonable alternative to redo surgery for the treatment of surgical mitral bioprosthetic valve failure. Here we report an 81-year-old female patient with surgical mitral bioprosthetic valve failure, who successfully underwent valve-in-valve transcatheter mitral valve replacement via the transfemoral-transseptal approach. The procedure was successful owing to comprehensive CT imaging work-up, despite the technical challenges associated with bilateral giant atria and small left ventricle.

1.	Yoon SH, Whisenant BK, Bleiziffer S, et al. Transcatheter mitral valve replacement for degenerated bioprosthetic valves and failed annuloplasty rings. J Am Coll Cardiol, 2017, 70(9): 1121-1131.
2.	Iung B, Vahanian A. Epidemiology of valvular heart disease in the adult. Nat Rev Cardiol, 2011, 8(3): 162-172.
3.	Nishimura RA, Vahanian A, Eleid MF, et al. Mitral valve disease--current management and future challenges. Lancet, 2016, 387(10025): 1324-1334.
4.	Mohty D, Orszulak TA, Schaff HV, et al. Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Circulation, 2001, 104(12 Suppl 1): I1-I7.
5.	王越夫, 姚彤, 王伟鹏, 等. 再次二尖瓣置换术中严重心血管事件原因分析及应对措施. 中国循环杂志, 2008, 23(5): 378-380.
6.	Mehaffey HJ, Hawkins RB, Schubert S, et al. Contemporary outcomes in reoperative mitral valve surgery. Heart, 2018, 104(8): 652-656.
7.	Cheung A, Webb JG, Wong DR, et al. Transapical transcatheter mitral valve-in-valve implantation in a human. Ann Thorac Surg, 2009, 87(3): e18-e20.
8.	Michelena HI, Alli O, Cabalka AK, et al. Successful percutaneous transvenous antegrade mitral valve-in-valve implantation. Catheter Cardiovasc Interv, 2013, 81(5): E219-224.
9.	Gheorghe LL, Mobasseri S, Agricola E, et al. Imaging for native mitral valve surgical and transcatheter interventions. JACC Cardiovasc Imaging, 2021, 14(1): 112-127.
10.	Montorfano M, Latib A, Chieffo A, et al. Successful percutaneous anterograde transcatheter valve-in-valve implantation in the mitral position. JACC Cardiovasc Interv, 2011, 4(11): 1246-1247.
11.	Babaliaros VC, Lederman RJ, Gleason PT, et al. The art of SAPIEN 3 transcatheter mitral valve replacement in valve-in-ring and valve-in-mitral-annular-calcification procedures. JACC Cardiovasc Interv, 2021, 14(20): 2195-2214.
12.	Guerrero M, Pursnani A, Narang A, et al. Prospective evaluation of transseptal TMVR for failed surgical bioprostheses: MITRAL trial valve-in-valve arm 1-year outcomes. JACC Cardiovasc Interv, 2021, 14(8): 859-872.
13.	Harloff MT, Chowdhury M, Hirji SA, et al. A step-by-step guide to transseptal valve-in-valve transcatheter mitral valve replacement. Ann Cardiothorac Surg, 2021, 10(1): 113-121.
14.	Cheung A, Webb JG, Barbanti M, et al. 5-year experience with transcatheter transapical mitral valve-in-valve implantation for bioprosthetic valve dysfunction. J Am Coll Cardiol, 2013, 61(17): 1759-1766.
15.	Bouleti C, Fassa AA, Himbert D, et al. Transfemoral implantation of transcatheter heart valves after deterioration of mitral bioprosthesis or previous ring annuloplasty. JACC Cardiovasc Interv, 2015, 8(1 Pt A): 83-91.
16.	Eleid MF, Cabalka AK, Williams MR, et al. Percutaneous transvenous transseptal transcatheter valve implantation in failed bioprosthetic mitral valves, ring annuloplasty, and severe mitral annular calcification. JACC Cardiovasc Interv, 2016, 9(11): 1161-1174.
17.	Frerker C, Schmidt T, Schlüter M, et al. Transcatheter implantation of aortic valve prostheses into degenerated mitral valve bioprostheses and failed annuloplasty rings: outcomes according to access route and Mitral Valve Academic Research Consortium (MVARC) criteria. EuroIntervention, 2016, 12(12): 1520-1526.
18.	Pasta S, Cannata S, Gentile G, et al. Simulation of left ventricular outflow tract (LVOT) obstruction in transcatheter mitral valve-in-ring replacement. Med Eng Phys, 2020, 82: 40-48.
19.	Barreiro-Perez M, Caneiro-Queija B, Puga L, et al. Imaging in transcatheter mitral valve replacement: state-of-art review. J Clin Med, 2021, 10(24): 5973.
20.	Reid A, Ben Zekry S, Turaga M, et al. Neo-LVOT and transcatheter mitral valve replacement: expert recommendations. JACC Cardiovasc Imaging, 2021, 14(4): 854-866.
21.	Wang DD, Guerrero M, Eng MH, et al. Alcohol septal ablation to prevent left ventricular outflow tract obstruction during transcatheter mitral valve replacement: first-in-man study. JACC Cardiovasc Interv, 2019, 12(13): 1268-1279.

1. Yoon SH, Whisenant BK, Bleiziffer S, et al. Transcatheter mitral valve replacement for degenerated bioprosthetic valves and failed annuloplasty rings. J Am Coll Cardiol, 2017, 70(9): 1121-1131.
2. Iung B, Vahanian A. Epidemiology of valvular heart disease in the adult. Nat Rev Cardiol, 2011, 8(3): 162-172.
3. Nishimura RA, Vahanian A, Eleid MF, et al. Mitral valve disease--current management and future challenges. Lancet, 2016, 387(10025): 1324-1334.
4. Mohty D, Orszulak TA, Schaff HV, et al. Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Circulation, 2001, 104(12 Suppl 1): I1-I7.
5. 王越夫, 姚彤, 王伟鹏, 等. 再次二尖瓣置换术中严重心血管事件原因分析及应对措施. 中国循环杂志, 2008, 23(5): 378-380.
6. Mehaffey HJ, Hawkins RB, Schubert S, et al. Contemporary outcomes in reoperative mitral valve surgery. Heart, 2018, 104(8): 652-656.
7. Cheung A, Webb JG, Wong DR, et al. Transapical transcatheter mitral valve-in-valve implantation in a human. Ann Thorac Surg, 2009, 87(3): e18-e20.
8. Michelena HI, Alli O, Cabalka AK, et al. Successful percutaneous transvenous antegrade mitral valve-in-valve implantation. Catheter Cardiovasc Interv, 2013, 81(5): E219-224.
9. Gheorghe LL, Mobasseri S, Agricola E, et al. Imaging for native mitral valve surgical and transcatheter interventions. JACC Cardiovasc Imaging, 2021, 14(1): 112-127.
10. Montorfano M, Latib A, Chieffo A, et al. Successful percutaneous anterograde transcatheter valve-in-valve implantation in the mitral position. JACC Cardiovasc Interv, 2011, 4(11): 1246-1247.
11. Babaliaros VC, Lederman RJ, Gleason PT, et al. The art of SAPIEN 3 transcatheter mitral valve replacement in valve-in-ring and valve-in-mitral-annular-calcification procedures. JACC Cardiovasc Interv, 2021, 14(20): 2195-2214.
12. Guerrero M, Pursnani A, Narang A, et al. Prospective evaluation of transseptal TMVR for failed surgical bioprostheses: MITRAL trial valve-in-valve arm 1-year outcomes. JACC Cardiovasc Interv, 2021, 14(8): 859-872.
13. Harloff MT, Chowdhury M, Hirji SA, et al. A step-by-step guide to transseptal valve-in-valve transcatheter mitral valve replacement. Ann Cardiothorac Surg, 2021, 10(1): 113-121.
14. Cheung A, Webb JG, Barbanti M, et al. 5-year experience with transcatheter transapical mitral valve-in-valve implantation for bioprosthetic valve dysfunction. J Am Coll Cardiol, 2013, 61(17): 1759-1766.
15. Bouleti C, Fassa AA, Himbert D, et al. Transfemoral implantation of transcatheter heart valves after deterioration of mitral bioprosthesis or previous ring annuloplasty. JACC Cardiovasc Interv, 2015, 8(1 Pt A): 83-91.
16. Eleid MF, Cabalka AK, Williams MR, et al. Percutaneous transvenous transseptal transcatheter valve implantation in failed bioprosthetic mitral valves, ring annuloplasty, and severe mitral annular calcification. JACC Cardiovasc Interv, 2016, 9(11): 1161-1174.
17. Frerker C, Schmidt T, Schlüter M, et al. Transcatheter implantation of aortic valve prostheses into degenerated mitral valve bioprostheses and failed annuloplasty rings: outcomes according to access route and Mitral Valve Academic Research Consortium (MVARC) criteria. EuroIntervention, 2016, 12(12): 1520-1526.
18. Pasta S, Cannata S, Gentile G, et al. Simulation of left ventricular outflow tract (LVOT) obstruction in transcatheter mitral valve-in-ring replacement. Med Eng Phys, 2020, 82: 40-48.
19. Barreiro-Perez M, Caneiro-Queija B, Puga L, et al. Imaging in transcatheter mitral valve replacement: state-of-art review. J Clin Med, 2021, 10(24): 5973.
20. Reid A, Ben Zekry S, Turaga M, et al. Neo-LVOT and transcatheter mitral valve replacement: expert recommendations. JACC Cardiovasc Imaging, 2021, 14(4): 854-866.
21. Wang DD, Guerrero M, Eng MH, et al. Alcohol septal ablation to prevent left ventricular outflow tract obstruction during transcatheter mitral valve replacement: first-in-man study. JACC Cardiovasc Interv, 2019, 12(13): 1268-1279.

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