Related Experiment Video

Updated: Sep 23, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

1.8K

Concomitant Redo Transcatheter Aortic Valve Replacement and Valve-in-Mitral Annular Calcification

Vinayak Nagaraja1, Nyal Borges1, Amar Krishnaswamy1

  • 1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

JACC. Case Reports
|May 16, 2022
PubMed

Insights

This case report details a successful simultaneous redo transcatheter aortic valve replacement and transcatheter mitral valve replacement for severe mitral annular calcification in a patient with radiation heart disease.

Area of Science:

  • Interventional Cardiology
  • Cardiac Surgery
  • Structural Heart Disease

Background:

  • Severe mitral annular calcification presents a significant challenge for transcatheter valve interventions.
  • Redo transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR) are complex procedures, especially when performed concomitantly.
  • Radiation heart disease can complicate structural heart interventions due to fibrotic changes.

Observation:

  • A patient with a history of radiation heart disease required both aortic and mitral valve interventions.
  • Severe mitral annular calcification precluded standard valve replacement techniques.
  • The patient underwent a combined redo TAVR and TMVR procedure.

Findings:

  • Successful implantation of both transcatheter valves was achieved.
  • The patient tolerated the concomitant procedures well.
  • This approach addressed severe mitral annular calcification and radiation-induced heart disease.

Implications:

  • Concomitant redo TAVR and TMVR is a feasible option for complex structural heart disease, including severe mitral annular calcification.
  • This case demonstrates a potential solution for patients with radiation heart disease requiring multiple valve interventions.
  • Further research is warranted to evaluate the long-term outcomes of combined TAVR and TMVR in challenging anatomies.

Keywords:
AR, aortic regurgitationASD, atrial septal defectLVOT, left ventricular outflow tractMAC, mitral annular calcificationMR, mitral regurgitationTAVR, transcatheter aortic valve replacementTMVR, transcatheter mitral valve replacementchemoradiotherapymitral valvemitral valve stenosistranscatheter aortic valve replacementtranscatheter mitral valve replacement

More Related Videos

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

4.0K
Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation06:59

Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

Published on: June 3, 2018

10.7K

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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...
31
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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...
37
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
56
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

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...
49
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
71
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

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...
60