Mitral regurgitation is the most common cardiac valve disease, with high rates of morbidity and mortality. Transcatheter mitral valve replacement (TMVR) is used as a promising intervention in non-surgical patients and in those with unsuitable anatomy for transcatheter edge-to-edge repair. TMVR can also be performed for inoperable or high-risk patients with degenerated or failed bioporstheses or failed repairs, or in patients with severe annular calcifications. The complex anatomy of the mitral valves makes the design of transcatheter mitral valve prostheses extremely challenging, and increases the difficulty of TMVR procedure, thus could led to non-negligible complications including periprocedural and post-procedural long-term complications. This review aims to discuss the potential TMVR-complications and measures implemented to mitigate these complications, in order to improve the prognosis of TMVR patients.
| 1. | 中国医师协会心血管内科医师分会结构性心脏病学组, 亚太结构性心脏病俱乐部. 中国经导管二尖瓣缘对缘修复术临床路径(2022 版)精简版. 中国介入心脏病学杂志, 2023, 31(3): 161-173. |
| 2. | Latib A, Ancona MB, Ferri L, et al. Percutaneous direct annuloplasty with cardioband to treat recurrent mitral regurgitation after MitraClip implantation. JACC Cardiovasc Interv, 2016, 9(18): e191-e192. |
| 3. | Alvarez-Covarrubias HA, Joner M, Lutz M, et al. Outcomes after transcatheter mitral valve implantation in valve-in-valve, valve-in-ring, and valve-in-mitral annular calcification. Catheter Cardiovasc Interv, 2024. |
| 4. | Guerrero ME, Eleid MF, Wang DD, et al. 5-year prospective evaluation of mitral valve-in-valve, valve-in-ring, and valve-in-MAC outcomes: MITRAL trial final results. JACC Cardiovasc Interv, 2023, 16(18): 2211-2227. |
| 5. | 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. |
| 6. | Guerrero M, Urena M, Himbert D, et al. 1-year outcomes of transcatheter mitral valve replacement in patients with severe mitral annular calcification. J Am Coll Cardiol, 2018, 71(17): 1841-1853. |
| 7. | Bapat VV, Khaliel F, Ihleberg L. Delayed migration of Sapien valve following a transcatheter mitral valve-in-valve implantation. Catheter Cardiovasc Interv, 2014, 83(1): E150-E154. |
| 8. | Binder RK, Webb JG. Transcatheter heart valve migration and embolization: rare and preventable?. Eur Heart J, 2019, 40(38): 3166-3168. |
| 9. | Stone GW, Adams DH, Abraham WT, et al. Clinical trial design principles and endpoint definitions for transcatheter mitral valve repair and replacement: part 2: endpoint definitions: a consensus document from the Mitral Valve Academic Research Consortium. J Am Coll Cardiol, 2015, 66(3): 308-321. |
| 10. | Yoon SH, Bleiziffer S, Latib A, et al. Predictors of left ventricular outflow tract obstruction after transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2019, 12(2): 182-193. |
| 11. | Blanke P, Naoum C, Dvir D, et al. Predicting LVOT obstruction in transcatheter mitral valve implantation: concept of the neo-LVOT. JACC Cardiovasc Imaging, 2017, 10(4): 482-485. |
| 12. | Wang DD, Eng MH, Greenbaum AB, et al. Validating a prediction modeling tool for left ventricular outflow tract (LVOT) obstruction after transcatheter mitral valve replacement (TMVR). Catheter Cardiovasc Interv, 2018, 92(2): 379-387. |
| 13. | Vaquerizo B, Theriault-Lauzier P, Piazza N. Percutaneous transcatheter mitral valve replacement: patient-specific three-dimensional computer-based heart model and prototyping. Rev Esp Cardiol (Engl Ed), 2015, 68(12): 1165-1173. |
| 14. | Meduri CU, Reardon MJ, Lim DS, et al. Novel multiphase assessment for predicting left ventricular outflow tract obstruction before transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2019, 12(23): 2402-2412. |
| 15. | 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. |
| 16. | El Sabbagh A, Eleid MF, Matsumoto JM, et al. Three-dimensional prototyping for procedural simulation of transcatheter mitral valve replacement in patients with mitral annular calcification. Catheter Cardiovasc Interv, 2018, 92(7): E537-E549. |
| 17. | Kvitting JP, Nielsen NE, Vanhanen I, et al. Surgical management of outflow tract obstruction after transapical mitral valve implantation. J Card Surg, 2018, 33(9): 545-547. |
| 18. | Greenbaum AB, Condado JF, Eng M, et al. Long or redundant leaflet complicating transcatheter mitral valve replacement: case vignettes that advocate for removal or reduction of the anterior mitral leaflet. Catheter Cardiovasc Interv, 2018, 92(3): 627-632. |
| 19. | Khan JM, Lederman RJ, Devireddy CM, et al. LAMPOON to facilitate tendyne transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2018, 11(19): 2014-2017. |
| 20. | Kamioka N, Greenbaum AB, Lederman RJ, et al. First application of the LAMPOON procedure to a surgical mitral bioprosthesis. Cardiovasc Revasc Med, 2023, 53S: S176-S179. |
| 21. | Guerrero M, Wang DD, Himbert D, et al. Short-term results of alcohol septal ablation as a bail-out strategy to treat severe left ventricular outflow tract obstruction after transcatheter mitral valve replacement in patients with severe mitral annular calcification. Catheter Cardiovasc Interv, 2017, 90(7): 1220-1226. |
| 22. | 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. |
| 23. | Kassar M, Khalique OK, Pilgrim T, et al. Surgical transatrial implantation of transcatheter heart valves in severe mitral annular calcification. Interv Cardiol Clin, 2019, 8(3): 313-319. |
| 24. | El Sabbagh A, Eleid MF, Foley TA, et al. Direct transatrial implantation of balloon-expandable valve for mitral stenosis with severe annular calcifications: early experience and lessons learned. Eur J Cardiothorac Surg, 2018, 53(1): 162-169. |
| 25. | Praz F, Khalique OK, Lee R, et al. Imaging in patients with severe mitral annular calcification: insights from a multicentre experience using transatrial balloon-expandable valve replacement. Eur Heart J Cardiovasc Imaging, 2019, 20(12): 1395-1406. |
| 26. | Doshi R, Shah P, Meraj PM. In-hospital outcomes comparison of transfemoral vs transapical transcatheter aortic valve replacement in propensity-matched cohorts with severe aortic stenosis. Clin Cardiol, 2018, 41(3): 326-332. |
| 27. | Ferrari E, Eeckhout E, Keller S, et al. Transfemoral versus transapical approach for transcatheter aortic valve implantation: hospital outcome and risk factor analysis. J Cardiothorac Surg, 2017, 12(1): 78. |
| 28. | Furukawa N, Kuss O, Emmel E, et al. Minimally invasive versus transapical versus transfemoral aortic valve implantation: a one-to-one-to-one propensity score-matched analysis. J Thorac Cardiovasc Surg, 2018, 156(5): 1825-1834. |
| 29. | Cruz-Gonzalez I, Rama-Merchan JC, Calvert PA, et al. Percutaneous closure of paravalvular leaks: a systematic review. J Interv Cardiol, 2016, 29(4): 382-392. |
| 30. | Whisenant B, Kapadia SR, Eleid MF, et al. One-year outcomes of mitral valve-in-valve using the SAPIEN 3 transcatheter heart valve. JAMA Cardiol, 2020, 5(11): 1245-1252. |
| 31. | Sorajja P, Moat N, Badhwar V, et al. Initial feasibility study of a new transcatheter mitral prosthesis: the first 100 patients. J Am Coll Cardiol, 2019, 73(11): 1250-1260. |
| 32. | Fukui M, Sorajja P, Gössl M, et al. Left ventricular remodeling after transcatheter mitral valve replacement with tendyne: new insights from computed tomography. JACC Cardiovasc Interv, 2020, 13(17): 2038-2048. |
| 33. | 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. |
| 34. | Aybek T, Risteski P, Miskovic A, et al. Seven years’ experience with suture annuloplasty for mitral valve repair. J Thorac Cardiovasc Surg, 2006, 131(1): 99-106. |
| 35. | Acar C. Re: Injury to the circumflex coronary artery following mitral valve repair. Eur J Cardiothorac Surg, 2007, 32(5): 818. |
| 36. | Bargagna M, Trumello C, Sala A, et al. Left circumflex artery injury after mitral valve surgery: an algorithm management proposal. Ann Thorac Surg, 2021, 111(3): 899-904. |
| 37. | Hiltrop N, Bennett J, Desmet W. Circumflex coronary artery injury after mitral valve surgery: a report of four cases and comprehensive review of the literature. Catheter Cardiovasc Interv, 2017, 89(1): 78-92. |
| 38. | Pagnesi M, Moroni F, Beneduce A, et al. Thrombotic risk and antithrombotic strategies after transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2019, 12(23): 2388-2401. |
| 39. | Heras M, Chesebro JH, Fuster V, et al. High risk of thromboemboli early after bioprosthetic cardiac valve replacement. J Am Coll Cardiol, 1995, 25(5): 1111-1119. |
| 40. | Brennan JM, Edwards FH, Zhao Y, et al. Early anticoagulation of bioprosthetic aortic valves in older patients: resultsfrom the Society of Thoracic Surgeons Adult Cardiac Surgery National Database. J Am Coll Cardiol, 2012, 60(11): 971-977. |
| 41. | Puri R, Auffret V, Rodés-Cabau J. Bioprosthetic valve thrombosis. J Am Coll Cardiol, 2017, 69(17): 2193-2211. |
| 42. | Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632. |
| 43. | Coisne A, Lancellotti P, Habib G, et al. ACC/AHA and ESC/EACTS guidelines for the management of valvular heart diseases: JACC guideline comparison. J Am Coll Cardiol, 2023, 82(8): 721-734. |
| 44. | Jilaihawi H, Asch FM, Manasse E, et al. Systematic CT methodology for the evaluation of subclinical leaflet thrombosis. JACC Cardiovasc Imaging, 2017, 10(4): 461-470. |
| 45. | Egbe AC, Pislaru SV, Pellikka PA, et al. Bioprosthetic valve thrombosis versus structural failure: clinical and echocardiographic predictors. J Am Coll Cardiol, 2015, 66(21): 2285-2294. |
| 46. | Regueiro A, Ye J, Fam N, et al. 2-Year outcomes after transcatheter mitral valve replacement. J Am Coll Cardiol Intv, 2017, 10(16): 1671-1678. |
| 47. | Bapat V, Rajagopal V, Meduri C, et al. Early experience with new transcatheter mitral valve replacement. J Am Coll Cardiol, 2018, 71(1): 12-21. |
| 48. | Urena M, Brochet E, Lecomte M, et al. Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: a 7-year experience. Eur Heart J, 2018, 39(28): 2679-2689. |
| 49. | Yoon SH, Whisenant BK, Bleiziffer S, et al. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J, 2019, 40(5): 441-451. |
| 50. | Taramasso M, Maisano F, Denti P, et al. Surgical treatment of paravalvular leak: long-term results in a single-center experience (up to 14 years). J Thorac Cardiovasc Surg, 2015, 149(5): 1270-1275. |
| 51. | El-Sabawi B, Guerrero ME, Eleid MF, et al. Hemolysis after transcatheter mitral valve replacement in degenerated bioprostheses, annuloplasty rings, and mitral annular calcification: Incidence, patient characteristics, and clinical outcomes. Catheter Cardiovasc Interv, 2021, 98(4): 776-785. |
| 52. | Asami M, Pilgrim T, Windecker S, et al. Case report of simultaneous transcatheter mitral valve-in-valve implantation and percutaneous closure of two paravalvular leaks. Eur Hear J Case Rep, 2019, 3(3): ytz123. |
| 53. | Cruz-Gonzalez I, Rama-Merchan JC, Rodríguez-Collado J, et al. Transcatheter closure of paravalvular leaks: state of the art. Neth Heart J, 2017, 25(2): 116-114. |
- 1. 中国医师协会心血管内科医师分会结构性心脏病学组, 亚太结构性心脏病俱乐部. 中国经导管二尖瓣缘对缘修复术临床路径(2022 版)精简版. 中国介入心脏病学杂志, 2023, 31(3): 161-173.
- 2. Latib A, Ancona MB, Ferri L, et al. Percutaneous direct annuloplasty with cardioband to treat recurrent mitral regurgitation after MitraClip implantation. JACC Cardiovasc Interv, 2016, 9(18): e191-e192.
- 3. Alvarez-Covarrubias HA, Joner M, Lutz M, et al. Outcomes after transcatheter mitral valve implantation in valve-in-valve, valve-in-ring, and valve-in-mitral annular calcification. Catheter Cardiovasc Interv, 2024.
- 4. Guerrero ME, Eleid MF, Wang DD, et al. 5-year prospective evaluation of mitral valve-in-valve, valve-in-ring, and valve-in-MAC outcomes: MITRAL trial final results. JACC Cardiovasc Interv, 2023, 16(18): 2211-2227.
- 5. 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.
- 6. Guerrero M, Urena M, Himbert D, et al. 1-year outcomes of transcatheter mitral valve replacement in patients with severe mitral annular calcification. J Am Coll Cardiol, 2018, 71(17): 1841-1853.
- 7. Bapat VV, Khaliel F, Ihleberg L. Delayed migration of Sapien valve following a transcatheter mitral valve-in-valve implantation. Catheter Cardiovasc Interv, 2014, 83(1): E150-E154.
- 8. Binder RK, Webb JG. Transcatheter heart valve migration and embolization: rare and preventable?. Eur Heart J, 2019, 40(38): 3166-3168.
- 9. Stone GW, Adams DH, Abraham WT, et al. Clinical trial design principles and endpoint definitions for transcatheter mitral valve repair and replacement: part 2: endpoint definitions: a consensus document from the Mitral Valve Academic Research Consortium. J Am Coll Cardiol, 2015, 66(3): 308-321.
- 10. Yoon SH, Bleiziffer S, Latib A, et al. Predictors of left ventricular outflow tract obstruction after transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2019, 12(2): 182-193.
- 11. Blanke P, Naoum C, Dvir D, et al. Predicting LVOT obstruction in transcatheter mitral valve implantation: concept of the neo-LVOT. JACC Cardiovasc Imaging, 2017, 10(4): 482-485.
- 12. Wang DD, Eng MH, Greenbaum AB, et al. Validating a prediction modeling tool for left ventricular outflow tract (LVOT) obstruction after transcatheter mitral valve replacement (TMVR). Catheter Cardiovasc Interv, 2018, 92(2): 379-387.
- 13. Vaquerizo B, Theriault-Lauzier P, Piazza N. Percutaneous transcatheter mitral valve replacement: patient-specific three-dimensional computer-based heart model and prototyping. Rev Esp Cardiol (Engl Ed), 2015, 68(12): 1165-1173.
- 14. Meduri CU, Reardon MJ, Lim DS, et al. Novel multiphase assessment for predicting left ventricular outflow tract obstruction before transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2019, 12(23): 2402-2412.
- 15. 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.
- 16. El Sabbagh A, Eleid MF, Matsumoto JM, et al. Three-dimensional prototyping for procedural simulation of transcatheter mitral valve replacement in patients with mitral annular calcification. Catheter Cardiovasc Interv, 2018, 92(7): E537-E549.
- 17. Kvitting JP, Nielsen NE, Vanhanen I, et al. Surgical management of outflow tract obstruction after transapical mitral valve implantation. J Card Surg, 2018, 33(9): 545-547.
- 18. Greenbaum AB, Condado JF, Eng M, et al. Long or redundant leaflet complicating transcatheter mitral valve replacement: case vignettes that advocate for removal or reduction of the anterior mitral leaflet. Catheter Cardiovasc Interv, 2018, 92(3): 627-632.
- 19. Khan JM, Lederman RJ, Devireddy CM, et al. LAMPOON to facilitate tendyne transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2018, 11(19): 2014-2017.
- 20. Kamioka N, Greenbaum AB, Lederman RJ, et al. First application of the LAMPOON procedure to a surgical mitral bioprosthesis. Cardiovasc Revasc Med, 2023, 53S: S176-S179.
- 21. Guerrero M, Wang DD, Himbert D, et al. Short-term results of alcohol septal ablation as a bail-out strategy to treat severe left ventricular outflow tract obstruction after transcatheter mitral valve replacement in patients with severe mitral annular calcification. Catheter Cardiovasc Interv, 2017, 90(7): 1220-1226.
- 22. 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.
- 23. Kassar M, Khalique OK, Pilgrim T, et al. Surgical transatrial implantation of transcatheter heart valves in severe mitral annular calcification. Interv Cardiol Clin, 2019, 8(3): 313-319.
- 24. El Sabbagh A, Eleid MF, Foley TA, et al. Direct transatrial implantation of balloon-expandable valve for mitral stenosis with severe annular calcifications: early experience and lessons learned. Eur J Cardiothorac Surg, 2018, 53(1): 162-169.
- 25. Praz F, Khalique OK, Lee R, et al. Imaging in patients with severe mitral annular calcification: insights from a multicentre experience using transatrial balloon-expandable valve replacement. Eur Heart J Cardiovasc Imaging, 2019, 20(12): 1395-1406.
- 26. Doshi R, Shah P, Meraj PM. In-hospital outcomes comparison of transfemoral vs transapical transcatheter aortic valve replacement in propensity-matched cohorts with severe aortic stenosis. Clin Cardiol, 2018, 41(3): 326-332.
- 27. Ferrari E, Eeckhout E, Keller S, et al. Transfemoral versus transapical approach for transcatheter aortic valve implantation: hospital outcome and risk factor analysis. J Cardiothorac Surg, 2017, 12(1): 78.
- 28. Furukawa N, Kuss O, Emmel E, et al. Minimally invasive versus transapical versus transfemoral aortic valve implantation: a one-to-one-to-one propensity score-matched analysis. J Thorac Cardiovasc Surg, 2018, 156(5): 1825-1834.
- 29. Cruz-Gonzalez I, Rama-Merchan JC, Calvert PA, et al. Percutaneous closure of paravalvular leaks: a systematic review. J Interv Cardiol, 2016, 29(4): 382-392.
- 30. Whisenant B, Kapadia SR, Eleid MF, et al. One-year outcomes of mitral valve-in-valve using the SAPIEN 3 transcatheter heart valve. JAMA Cardiol, 2020, 5(11): 1245-1252.
- 31. Sorajja P, Moat N, Badhwar V, et al. Initial feasibility study of a new transcatheter mitral prosthesis: the first 100 patients. J Am Coll Cardiol, 2019, 73(11): 1250-1260.
- 32. Fukui M, Sorajja P, Gössl M, et al. Left ventricular remodeling after transcatheter mitral valve replacement with tendyne: new insights from computed tomography. JACC Cardiovasc Interv, 2020, 13(17): 2038-2048.
- 33. 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.
- 34. Aybek T, Risteski P, Miskovic A, et al. Seven years’ experience with suture annuloplasty for mitral valve repair. J Thorac Cardiovasc Surg, 2006, 131(1): 99-106.
- 35. Acar C. Re: Injury to the circumflex coronary artery following mitral valve repair. Eur J Cardiothorac Surg, 2007, 32(5): 818.
- 36. Bargagna M, Trumello C, Sala A, et al. Left circumflex artery injury after mitral valve surgery: an algorithm management proposal. Ann Thorac Surg, 2021, 111(3): 899-904.
- 37. Hiltrop N, Bennett J, Desmet W. Circumflex coronary artery injury after mitral valve surgery: a report of four cases and comprehensive review of the literature. Catheter Cardiovasc Interv, 2017, 89(1): 78-92.
- 38. Pagnesi M, Moroni F, Beneduce A, et al. Thrombotic risk and antithrombotic strategies after transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2019, 12(23): 2388-2401.
- 39. Heras M, Chesebro JH, Fuster V, et al. High risk of thromboemboli early after bioprosthetic cardiac valve replacement. J Am Coll Cardiol, 1995, 25(5): 1111-1119.
- 40. Brennan JM, Edwards FH, Zhao Y, et al. Early anticoagulation of bioprosthetic aortic valves in older patients: resultsfrom the Society of Thoracic Surgeons Adult Cardiac Surgery National Database. J Am Coll Cardiol, 2012, 60(11): 971-977.
- 41. Puri R, Auffret V, Rodés-Cabau J. Bioprosthetic valve thrombosis. J Am Coll Cardiol, 2017, 69(17): 2193-2211.
- 42. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
- 43. Coisne A, Lancellotti P, Habib G, et al. ACC/AHA and ESC/EACTS guidelines for the management of valvular heart diseases: JACC guideline comparison. J Am Coll Cardiol, 2023, 82(8): 721-734.
- 44. Jilaihawi H, Asch FM, Manasse E, et al. Systematic CT methodology for the evaluation of subclinical leaflet thrombosis. JACC Cardiovasc Imaging, 2017, 10(4): 461-470.
- 45. Egbe AC, Pislaru SV, Pellikka PA, et al. Bioprosthetic valve thrombosis versus structural failure: clinical and echocardiographic predictors. J Am Coll Cardiol, 2015, 66(21): 2285-2294.
- 46. Regueiro A, Ye J, Fam N, et al. 2-Year outcomes after transcatheter mitral valve replacement. J Am Coll Cardiol Intv, 2017, 10(16): 1671-1678.
- 47. Bapat V, Rajagopal V, Meduri C, et al. Early experience with new transcatheter mitral valve replacement. J Am Coll Cardiol, 2018, 71(1): 12-21.
- 48. Urena M, Brochet E, Lecomte M, et al. Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: a 7-year experience. Eur Heart J, 2018, 39(28): 2679-2689.
- 49. Yoon SH, Whisenant BK, Bleiziffer S, et al. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J, 2019, 40(5): 441-451.
- 50. Taramasso M, Maisano F, Denti P, et al. Surgical treatment of paravalvular leak: long-term results in a single-center experience (up to 14 years). J Thorac Cardiovasc Surg, 2015, 149(5): 1270-1275.
- 51. El-Sabawi B, Guerrero ME, Eleid MF, et al. Hemolysis after transcatheter mitral valve replacement in degenerated bioprostheses, annuloplasty rings, and mitral annular calcification: Incidence, patient characteristics, and clinical outcomes. Catheter Cardiovasc Interv, 2021, 98(4): 776-785.
- 52. Asami M, Pilgrim T, Windecker S, et al. Case report of simultaneous transcatheter mitral valve-in-valve implantation and percutaneous closure of two paravalvular leaks. Eur Hear J Case Rep, 2019, 3(3): ytz123.
- 53. Cruz-Gonzalez I, Rama-Merchan JC, Rodríguez-Collado J, et al. Transcatheter closure of paravalvular leaks: state of the art. Neth Heart J, 2017, 25(2): 116-114.