Mitro-aortic valve-in-valve procedures: Many challenges in little space

J Card Surg. 2020 Aug;35(8):2089-2092. doi: 10.1111/jocs.14806. Epub 2020 Jul 11.

Abstract

Multiple valve replacements are known to carry additional risk of morbidity and mortality in redo context. Currently, a transcatheter-based valve-in-valve approach could be useful in reducing potential serious consequences. On the other hand, this approach poses several technical challenges regarding the device and the procedural aspects. We present the case of a 78-year-old man who presented with symptoms of heart failure due to mitral and aortic bioprosthesis degenerations who was deemed to be at extremely high risk for a conventional redo surgery. A two-step transcatheter-based approach was planned and a transfemoral aortic valve-in-valve procedure was followed by a transapical mitral valve-in-valve implantation with a favorable early and long-term outcome.

Keywords: TAVR; redo surgery; transcatheter mitral valve replacement; valve-in-valve.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / surgery
  • Bioprosthesis*
  • Cardiac Catheterization / methods*
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Male
  • Mitral Valve / surgery*
  • Mitral Valve Stenosis / surgery
  • Patient Care Team
  • Reoperation
  • Stroke Volume
  • Transcatheter Aortic Valve Replacement / methods*
  • Treatment Outcome