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REVIEWS  RECENT ADVANCES IN TRANSCATHETER MITRAL VALVE REPLACEMENT 

The Journal of Cardiovascular Surgery 2016 June;57(3):372-80

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Mitral valve-in-valve and valve-in-ring for failing surgical bioprosthetic valves and rings

Michael GHOSH-DASTIDAR, Ashok NARAYANA, Ricardo BOIX, Vinayak BAPAT

Department of Cardiothoracic Surgery, St. Thomas’ Hospital, London, UK


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The transcatheter valve-in-valve (VIV) procedure for failed aortic bioprostheses is recognized as an alternative treatment to conventional surgery in high-risk patients. This less invasive option has now been applied to failed mitral bioprostheses (VIV) or failed repairs i.e. valve-in-ring (VIR). In this emerging field, to get an optimal result, a good understanding of the design features of the failed surgical heart valve/ring, the transcatheter heart valve being used and their compatibility, is of paramount importance. Although similar in many ways to the aortic counterpart, a mitral VIV/VIR procedure can pose certain different challenges such as delayed migration and left ventricular outflow tract obstruction. This review describes the features of bioprostheses, rings and THVs relevant to a VIV/VIR procedure, and also provides guidance regarding sizing, positioning and how to avoid some of the major complications therefore improving the chances of a successful outcome.

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