Related Experiment Video
Updated: Dec 15, 2025
08:50
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
12.1K
Transcatheter aortic valve replacement in patients with previous mitral valve replacement. A systematic study
Zbigniew Chmielak1, Maciej Dąbrowski1, Paweł Tyczyński1
1Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
Summary
Transcatheter aortic valve implantation (TAVI) is feasible in patients with severe aortic stenosis who previously had mitral valve replacement (MVR). Careful pre-procedural planning is crucial for successful outcomes in this high-risk group.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Severe aortic stenosis (AS) is a growing concern in aging populations.
- Transcatheter aortic valve implantation (TAVI) has transformed AS treatment.
- TAVI post-mitral valve replacement (MVR) carries risks, with limited data available.
Purpose of the Study:
- To assess outcomes of TAVI in patients with prior MVR.
- Evaluate clinical, echocardiographic, and CT findings.
- Analyze procedural success, complications, and long-term adverse events.
Main Methods:
- Retrospective analysis of 17 patients undergoing TAVI with prior mitral valve operations (15 with MVR).
- Data collected included pre-procedural measurements and post-procedural outcomes.
- Follow-up assessed valve interventions and major adverse cardiovascular events (MACE) per VARC-2 criteria.
Main Results:
- TAVI significantly reduced transaortic gradients (mean 38.3 mmHg, max 58.6 mmHg, p < 0.001).
- Immediate procedural success was high (93.3%).
- No significant changes in transmitral gradients or mitral regurgitation were observed; one tamponade occurred and was treated.
Conclusions:
- TAVI is a feasible option for patients with AS and prior MVR.
- Thorough pre-procedural imaging (echocardiography, CT) is essential.
- Transesophageal echocardiography (TEE) guidance may not be mandatory.
Related Concept Videos
01:26Mitral Stenosis III: Medical Management
159
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
159
01:25Mitral Regurgitation III: Medical Management
179
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
179
01:22Mitral Valve Prolapse II: Assessment and Management
249
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
249
01:22Mitral Stenosis I: Introduction
234
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
234
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
131
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
131
01:23Mitral Regurgitation II: Clinical Features and Diagnostic Tests
199
Mitral regurgitation (MR) is a valvular heart disorder in which the mitral valve fails to close tightly, allowing blood to leak backward into the heart. Understanding the clinical manifestations, assessment, diagnostic findings, and medical management of MR is crucial to effectively managing affected patients.Clinical Manifestations of Mitral RegurgitationMitral regurgitation can be acute or chronic, each presenting differently and requiring different approaches:1. Acute Mitral...
199