'Fast-implantable' aortic valve implantation and concomitant mitral procedures

Area of Science:

• Cardiac Surgery
• Cardiovascular Medicine
• Bioprosthetic Heart Valves

Background:

• Concomitant aortic and mitral valve surgery presents challenges due to potential interference between prosthetic devices at the mitroaortic junction.
• The Intuity valve system is a 'fast-implantable' aortic valve alternative for complex cases, but its use with existing mitral prostheses is debated.

Observation:

• Transcatheter aortic valve replacements have been successfully performed in patients with prior mitral valve or ring implantation without significant interference.
• This suggests that the Intuity valve, a fast-implantable system, may also be safely implanted adjacent to mitral bioprostheses or rigid mitral rings.

Findings:

• Two cases demonstrate successful concomitant implantation of the Intuity aortic valve with a bioprosthetic mitral valve and with a mitral ring.
• No significant interference, distortion, malpositioning, high gradient, or paravalvular leak was observed in these combined procedures.

Implications:

• The Intuity valve system may be a viable and safe option for complex concomitant aortic and mitral valve interventions.
• This approach could expand treatment options for high-risk patients requiring combined valve procedures, potentially reducing surgical risks.