EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
-
As transcatheter mitral replacement technologies have recently been applied in early clinical trials, the question as to whether valve implantation would have the potential to become the leading percutaneous mitral valve therapy has been raised. The aim of this report is to give an overview of the different peculiarities of percutaneous replacement and repair techniques, and to predict whether the two approaches will have a complementary rather than a competitive clinical role in the near future.
-
There is a growing practice of transcatheter treatment of failed mitral valves after cardiac surgery, including valve-in-valve and valve-in-ring. Although commonly successful, these procedures can be associated with device malposition (including delayed malposition) and elevated post-procedural gradients (especially when performed inside small surgical valves). Valve-in-ring procedures have elevated risks of left ventricular outflow tract obstruction and post-procedural regurgitation. Careful patient selection and meticulous evaluation of patient anatomy and surgical implant characteristics are essential to achieve optimal clinical results with mitral valve-in-valve and valve-in-ring implantation.