Related Experiment Video
Updated: May 20, 2026
08:12
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Off-pump transapical mitral valve-in-ring implantation.
Yu Zou1, Enrico Ferrari, Ludwig K von Segesser
1Department of Cardiac Surgery, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, China. zou123123yu@163.com
Summary
Off-pump transapical mitral valve-in-ring implantation is safe and feasible for high-risk patients. A custom-made nitinol stent valve achieved a near-normal functional area compared to the SAPIEN valve.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Biomedical Engineering
Background:
- Mitral valve repair can be complicated by recurrent mitral regurgitation.
- Transcatheter valve-in-ring implantation offers a potential solution for high-risk patients.
- Evaluating novel stent valve performance is crucial for advancing treatment options.
Purpose of the Study:
- To assess the feasibility of off-pump transapical mitral valve-in-ring implantation.
- To compare the performance of a custom-made self-expandable stent valve against the SAPIEN valve.
- To determine the safety and efficacy of transapical access for valve-in-ring procedures.
Main Methods:
- Acute experiments were conducted in five pigs following mitral valve annuloplasty.
- Both custom-made self-expandable and SAPIEN transcatheter heart valves were deployed within annuloplasty rings.
- Transatrial and transapical implantation techniques were utilized under direct vision and fluoroscopic guidance, respectively, with off-pump procedures.
Main Results:
- Procedural success rate was 100% for both transatrial and transapical mitral valve-in-ring procedures.
- The custom-made self-expandable stent valve group demonstrated a larger mitral annulus diameter and orifice area.
- Trace to mild regurgitation was observed only in the self-expandable stent valve group, with stable hemodynamics during implantation.
Conclusions:
- Off-pump transapical mitral valve-in-ring implantation is a safe and feasible procedure.
- Transapical access is a promising approach for valve-in-ring procedures in patients with recurrent mitral regurgitation.
- The custom-made nitinol stent valve offers a superior functional area compared to the SAPIEN valve due to its supra-annular design.
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