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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Transcatheter "valve-in-valve" mitral valve replacement for patient-prosthesis mismatch: Chronicle of a death

Mateo Marin-Cuartas1, Thilo Noack1, Philipp Kiefer1

  • 1University Department of Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany.

Journal of Cardiac Surgery
|September 28, 2020
PubMed

Insights

Severe mitral annular calcification (MAC) poses risks like patient-prosthesis mismatch (PPM). Alternative techniques are crucial for mitral valve replacement in MAC patients to prevent PPM and ensure better outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Severe mitral annular calcification (MAC) presents significant challenges in mitral valve replacement.
  • Patient-prosthesis mismatch (PPM) is a potential complication associated with MAC, leading to adverse outcomes.

Observation:

  • MAC can complicate the selection of appropriately sized bioprostheses during mitral valve replacement.
  • Transcatheter valve-in-valve replacement may be unsuitable in MAC patients due to the high risk of PPM.

Findings:

  • Alternative surgical techniques are necessary to ensure adequate bioprosthesis sizing in MAC patients.
  • PPM must be avoided to prevent poor clinical outcomes and premature prosthetic degeneration.

Implications:

  • Developing and utilizing alternative mitral valve replacement strategies is critical for patients with severe MAC.
  • Recognizing PPM as a contraindication for transcatheter valve-in-valve replacement in MAC is essential for patient safety and prosthesis longevity.
Keywords:
mitral annular calcificationmitral valvepatient-prosthesis mismatchtranscatheter valve replacementvalve-in-valve

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