Transcatheter mitral valve implantation in rigid mitral annuloplasty rings: Potential differences between complete and incomplete rings

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Daisuke HachinoheAntonio Colombo

Abstract

Transcatheter mitral valve implantation (TMVI) has been performed in high-risk and inoperable patients for degenerated mitral bioprostheses (TMVIinV) and failed annuloplasty rings (TMVIinR). TMVIinR is more challenging compared to TMVIinV because of the differences in dimensions, shapes, and contours between rings and valves. In this report, we present two clinical cases of TMVIinR that were treated by trans-septal implantation of a balloon-expandable prosthesis. In TMVI cases with an incomplete ring, the ring will be stretched out toward its anterior and commissural side, and the open side of the ring will increase in width. The ring may not transform in line with the shape of the transcatheter heart valve (THV) and an interspace can develop between the THV and the ring at the commissural side, resulting in significant paravalvular regurgitation. Our experience suggests that the circumferential completeness of the rings may be an important factor to consider when planning a TMVIinR.

References

Sep 27, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Vinayak Bapat
Feb 22, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Vinayak Bapat
Aug 26, 2017·Journal of the American College of Cardiology·Sung-Han YoonRaj R Makkar

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