Successful transfemoral antegrade valve-in-valve implantation of a SAPIEN XT valve into a degenerated mitral valve prosthesis

• Verfasst von: Bekeredjian, Raffi [VerfasserIn]
• Verfasst von: Chorianopoulos, Emmanuel [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Titel: Successful transfemoral antegrade valve-in-valve implantation of a SAPIEN XT valve into a degenerated mitral valve prosthesis
• Verf.angabe: Raffi Bekeredjian, Emmanuel Chorianopoulos, Hugo A. Katus
• Umfang: 3 S.
• Fussnoten: DOI nicht vorhanden
• Titel Quelle: Enthalten in: The journal of invasive cardiology
• Jahr Quelle: 2012
• Band/Heft Quelle: 24(2012), 4, S. 170-172
• ISSN Quelle: 1557-2501
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1583754849

Abstract

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 wasused 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.