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Updated: Mar 12, 2026
08:31
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Transcatheter Mitral Valve-in-Valve Therapy
Jose F Condado1, Brian Kaebnick1, Vasilis Babaliaros1
1Division of Cardiology, Structural Heart and Valve Center, Emory University School of Medicine, Atlanta, GA, USA.
Interventional Cardiology Clinics
|November 18, 2016
Summary
Transcatheter mitral valve replacement offers a less invasive option for inoperable patients with failing bioprosthetic valves. This procedure, guided by advanced imaging, shows high success rates despite potential complications.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter mitral valve replacement (TMVR) is an option for inoperable patients with failing surgical mitral bioprostheses or repairs.
- This minimally invasive approach addresses a critical need in a high-risk patient population.
Purpose of the Study:
- To describe the utility of valve-in-valve and valve-in-ring transcatheter mitral valve replacement.
- To outline the preprocedural imaging requirements and procedural considerations for TMVR.
Main Methods:
- Preprocedural evaluation involves a heart team approach using transthoracic echocardiogram, transesophageal echocardiogram, and cardiac computed tomography angiography (CTA).
- CTA is crucial for determining optimal access site (transapical, transseptal, transatrial), selecting transcatheter valve size, and defining the landing zone.
Main Results:
- The procedure has reported success rates ranging from 70% to 100%.
- Complications such as valve embolization, bleeding, and vascular issues can occur but are managed within the procedural context.
Conclusions:
- Valve-in-valve and valve-in-ring TMVR are increasingly utilized, effective treatments for inoperable patients with degenerated mitral bioprostheses.
- Multimodality imaging is essential for successful TMVR planning and execution.
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