Successful transfemoral antegrade valve-in-valve implantation of a SAPIEN XT valve into a degenerated mitral valve prosthesis
Transfemoral aortic valve implantation has become an important interventional technique for patients with severe aortic stenosis and high surgical risks. The mitral valve has been a much greater challenge for interventional procedures, and no percutaneous mitral valve implantation system has yet bee...
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| Main Authors: | , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2012
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| In: |
The journal of invasive cardiology
Year: 2012, Volume: 24, Issue: 4, Pages: 170-172 |
| ISSN: | 1557-2501 |
| Online Access: | Verlag, Volltext: https://www.invasivecardiology.com/articles/successful-transfemoral-antegrade-valve-valve-implantation-sapien-xt-valve-degenerated-mitr
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| Author Notes: | Raffi Bekeredjian, Emmanuel Chorianopoulos, Hugo A. Katus |
MARC
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| 245 | 1 | 0 | |a Successful transfemoral antegrade valve-in-valve implantation of a SAPIEN XT valve into a degenerated mitral valve prosthesis |c Raffi Bekeredjian, Emmanuel Chorianopoulos, Hugo A. Katus |
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| 520 | |a Transfemoral aortic valve implantation has become an important interventional technique for patients with severe aortic stenosis and high surgical risks. The mitral valve has been a much greater challenge for interventional procedures, and no percutaneous mitral valve implantation system has yet been developed and approved. Here, we report the successful transfemoral, antegrade, valve-in-valve implantation of the SAPIEN XT valve (Edwards Lifesciences) into a degenerated mitral valve bioprosthesis. The patient was an 81-year-old woman with severe regurgitation of her 27 mm Epic mitral valve prosthesis (St. Jude Medical), suffering from dyspnea on mild exertion with a calculated logistic EuroScore of 48% and an Society of Thoracic Surgeons score of 29%. Thus, another surgical mitral valve replacement was refused by the patient and was considered as extremely high risk by the cardiac surgeon. Therefore, a transfemoral valve-in-valve implantation was planned. The femoral vein was used as an access site, followed by a transseptal puncture and placement of a super-stiff wire into the left ventricle. Then, the septum was dilated and a 26 mm SAPIEN XT valve was inserted through the septum and then inserted into the mitral valve prosthesis. Under rapid pacing, a very slow inflation of the balloon was performed, leading to a stable valve-in-valve implantation without any regurgitation. The patient was transferred to a normal ward after 2 days. This procedure is an off-label, technically very challenging, high-risk implantation that could be attempted in very select patients after discussion by a heart team and by experienced implanters. | ||
| 650 | 4 | |a Aged, 80 and over | |
| 650 | 4 | |a Catheterization | |
| 650 | 4 | |a Female | |
| 650 | 4 | |a Femoral Vein | |
| 650 | 4 | |a Heart Valve Prosthesis | |
| 650 | 4 | |a Heart Valve Prosthesis Implantation | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Mitral Valve | |
| 650 | 4 | |a Mitral Valve Insufficiency | |
| 650 | 4 | |a Treatment Outcome | |
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