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Updated: Aug 23, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Off-label transapical beating-heart transcatheter mitral valve replacement in severe mitral annular calcification
Tillmann Kerbel1, Markus Mach1, Anna Bartunek2
1Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
Abstract:
The recent CE mark approval of a novel transapical transcatheter beating-heart replacement system, anchored by an apical pad, expanded the therapeutic options for patients with a significantly diseased mitral valve who are not eligible for conventional surgery. However, this self-expandable bioprosthesis is-despite promising data from the first European real-world experience-not approved for patients with severe mitral annular calcification. In this video tutorial, we provide a step-by-step description of an off-label transapical mitral valve replacement in a patient with severe degenerative mitral valve disease and limited alternative treatment options.
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