Transapical transcatheter valve-in-valve implantation treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WEI Peijian ^1,2 ,  LIU Jian ¹ , XIE Nianjin ³ , TAN Tong ^1,2 , MA Jiexu ^1,2 , CHEN Zhao ¹ , LIU Yanjun ¹ , WU Hongxiang ¹ , HUANG Huanlei ¹ , CHEN Jimei ¹ , ZHUANG Jian ¹ ,  GUO Huiming ¹

1. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China;
2. Shantou University Medical College, Shantou, 515041, Guangdong, P.R.China;
3. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China;

Corresponding author：

LIU Jian, Email: jianliu_gdpph@sina.com; GUO Huiming, Email: guohuiming@gdph.org.cn

Keywords：

Transapical transcatheter therapy; valve-in-valve; aortic-mitral double valve replacement; bioprosthesis deterioration

DOI：

10.7507/1007-4848.202104066

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Objective To determine the clinical efficacy of transapical transcatheter mitral valve-in-valve treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement.Methods The clinical data of 9 patients who underwent transapical transcatheter mitral valve-in-valve implantation after aortic-mitral double valve replacement due to mitral bioprosthesis deterioration from May 2020 to January 2021 in our hospital were retrospectively analyzed, including 4 males and 5 females with a mean age of 72.44±7.57 years.Results Surgeries were performed successfully in all patients with no conversion to median sternotomy. The mean procedural time was 101.33±48.49 min, the mechanical ventilation time was 23.11±26.54 h, the ICU stay was 1.89±1.05 d and the postoperative hospital stay was 6.11±2.02 d. Residual mild mitral regurgitation was only observed in 1 patient. Only 1 patient needed postoperative blood transfusion. No major complications were observed in all patients. There was no death in postoperative 90 days.Conclusion For patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement, transapical transcatheter mitral valve-in-valve implantation achieves good clinical results and effectively improves the hemodynamics without increasing the risk of postoperative left ventricular outflow tract obstruction. The surgery is feasible and effective.

Citation： WEI Peijian, LIU Jian, XIE Nianjin, TAN Tong, MA Jiexu, CHEN Zhao, LIU Yanjun, WU Hongxiang, HUANG Huanlei, CHEN Jimei, ZHUANG Jian, GUO Huiming. Transapical transcatheter valve-in-valve implantation treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(8): 901-907. doi: 10.7507/1007-4848.202104066 Copy

1.	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告 2019 概要. 中华老年病研究电子杂志, 2020, 7(4): 4-15.
2.	Lee R, Li S, Rankin JS, et al. Fifteen-year outcome trends for valve surgery in North America. Ann Thorac Surg, 2011, 91(3): 677-684.
3.	Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): e25-e197.
4.	Fujita B, Ensminger S, Bauer T, et al. Trends in practice and outcomes from 2011 to 2015 for surgical aortic valve replacement: An update from the German Aortic Valve Registry on 42 776 patients. Eur J Cardiothorac Surg, 2018, 53(3): 552-559.
5.	Vohra HA, Whistance RN, Roubelakis A, et al. Outcome after redo-mitral valve replacement in adult patients: A 10-year single-centre experience. Interact Cardiovasc Thorac Surg, 2012, 14(5): 575-579.
6.	Chauvaud S, Fuzellier JF, Berrebi A, et al. Long-term (29 years) results of reconstructive surgery in rheumatic mitral valve insufficiency. Circulation, 2001, 104(12 Suppl 1): Ⅰ12-Ⅰ15.
7.	Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: First human case description. Circulation, 2002, 106(24): 3006-3008.
8.	张海波, 孟旭, 王胜洵, 等. 经导管二尖瓣生物瓣毁损的瓣中瓣治疗技术. 中华胸心血管外科杂志, 2019, 35(6): 331-333.
9.	Bapat V. Valve-in-valve apps: Why and how they were developed and how to use them. EuroIntervention, 2014, 10(Suppl U): U44-U51.
10.	Shreenivas S, Kaneko T, Tang GHL. Predicting the future of TAVR: An obituary to open aortic valve replacement? Curr Opin Cardiol, 2019, 34(2): 112-123.
11.	Wenaweser P, Buellesfeld L, Gerckens U, et al. Percutaneous aortic valve replacement for severe aortic regurgitation in degenerated bioprosthesis: The first valve in valve procedure using the Corevalve Revalving system. Catheter Cardiovasc Interv, 2007, 70(5): 760-764.
12.	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.
13.	Simonato M, Whisenant B, Ribeiro HB, et al. Transcatheter mitral valve replacement after surgical repair or replacement: Comprehensive midterm evaluation of valve-in-valve and valve-in-ring implantation from the VIVID Registry. Circulation, 2021, 143(2): 104-116.
14.	Shivaraju A, Michel J, Frangieh AH, et al. Transcatheter aortic and mitral valve-in-valve implantation using the Edwards Sapien 3 heart valve. J Am Heart Assoc, 2018, 7(14): e007767.
15.	党梦秋, 范嘉祺, 朱齐丰, 等. 《经导管主动脉瓣置换术中国专家共识(2020 更新版)》解读. 心电与循环, 2021, 40(1): 1-5.

1. 中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告 2019 概要. 中华老年病研究电子杂志, 2020, 7(4): 4-15.
2. Lee R, Li S, Rankin JS, et al. Fifteen-year outcome trends for valve surgery in North America. Ann Thorac Surg, 2011, 91(3): 677-684.
3. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): e25-e197.
4. Fujita B, Ensminger S, Bauer T, et al. Trends in practice and outcomes from 2011 to 2015 for surgical aortic valve replacement: An update from the German Aortic Valve Registry on 42 776 patients. Eur J Cardiothorac Surg, 2018, 53(3): 552-559.
5. Vohra HA, Whistance RN, Roubelakis A, et al. Outcome after redo-mitral valve replacement in adult patients: A 10-year single-centre experience. Interact Cardiovasc Thorac Surg, 2012, 14(5): 575-579.
6. Chauvaud S, Fuzellier JF, Berrebi A, et al. Long-term (29 years) results of reconstructive surgery in rheumatic mitral valve insufficiency. Circulation, 2001, 104(12 Suppl 1): Ⅰ12-Ⅰ15.
7. Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: First human case description. Circulation, 2002, 106(24): 3006-3008.
8. 张海波, 孟旭, 王胜洵, 等. 经导管二尖瓣生物瓣毁损的瓣中瓣治疗技术. 中华胸心血管外科杂志, 2019, 35(6): 331-333.
9. Bapat V. Valve-in-valve apps: Why and how they were developed and how to use them. EuroIntervention, 2014, 10(Suppl U): U44-U51.
10. Shreenivas S, Kaneko T, Tang GHL. Predicting the future of TAVR: An obituary to open aortic valve replacement? Curr Opin Cardiol, 2019, 34(2): 112-123.
11. Wenaweser P, Buellesfeld L, Gerckens U, et al. Percutaneous aortic valve replacement for severe aortic regurgitation in degenerated bioprosthesis: The first valve in valve procedure using the Corevalve Revalving system. Catheter Cardiovasc Interv, 2007, 70(5): 760-764.
12. 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.
13. Simonato M, Whisenant B, Ribeiro HB, et al. Transcatheter mitral valve replacement after surgical repair or replacement: Comprehensive midterm evaluation of valve-in-valve and valve-in-ring implantation from the VIVID Registry. Circulation, 2021, 143(2): 104-116.
14. Shivaraju A, Michel J, Frangieh AH, et al. Transcatheter aortic and mitral valve-in-valve implantation using the Edwards Sapien 3 heart valve. J Am Heart Assoc, 2018, 7(14): e007767.
15. 党梦秋, 范嘉祺, 朱齐丰, 等. 《经导管主动脉瓣置换术中国专家共识(2020 更新版)》解读. 心电与循环, 2021, 40(1): 1-5.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Transapical transcatheter valve-in-valve implantation treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement

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