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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
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[Simultaneous transcatheter transapical native mitral and aortic valve implantation]
Massimo Fineschi1, Giuseppe Sinicropi1, Alessandro Iadanza1
1U.O.S.A. Cardiologia Interventistica.
Giornale Italiano Di Cardiologia (2006)
|March 28, 2022
Summary
This study presents a novel transcatheter double valve replacement for severe aortic and mitral stenosis in a high-risk patient. This approach offers a life-saving alternative for complex valve disease when traditional surgery is not an option.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter aortic valve replacement (TAVR) is established for severe aortic stenosis in high-risk patients.
- Transcatheter mitral valve replacement (TMVR) is emerging for high-risk patients with specific mitral valve conditions.
- Simultaneous TAVR and TMVR in native valves is complex, with left ventricular outflow tract obstruction being a significant risk.
Observation:
- A 77-year-old female patient presented with severe symptomatic aortic and mitral stenosis.
- The patient had severe mitral annular calcification (MAC) and was not a candidate for traditional surgery.
- Simultaneous transcatheter double valve replacement was performed via transapical access.
Findings:
- The procedure involved simultaneous transcatheter aortic valve replacement and transcatheter mitral valve replacement into native valves.
- Transapical access was utilized for the dual valve intervention.
- Successful implantation of both valves was achieved in a patient with complex native valve disease and MAC.
Implications:
- This case demonstrates the feasibility of simultaneous transcatheter double valve replacement in a complex, high-risk patient.
- Careful preprocedural imaging and planning are crucial to mitigate complications like left ventricular outflow tract obstruction.
- This approach may offer a viable treatment option for carefully selected patients with severe, concomitant aortic and mitral stenosis unsuitable for surgery.
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