Transapical Mitral Valve-in-Ring Replacement Using the Innovative System under 3-Dimensional Printing Guidance

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Medical Device Innovation

Background:

• Transcatheter mitral valve-in-ring replacement (TMViR) is an emerging treatment for recurrent mitral regurgitation (MR) post-annuloplasty ring failure.
• High-risk surgical reoperation is often a concern for these patients.
• Intraoperative challenges in TMViR require innovative solutions.

Observation:

• A 67-year-old male with recurrent severe MR (NYHA Class IV) after prior mitral and tricuspid annuloplasty underwent TMViR.
• A novel Mi-thos system was used via a transapical approach.
• A patient-specific 3D printed model guided the procedure, mitigating potential complications.

Findings:

• The Mi-thos system was successfully deployed in a TMViR procedure.
• The 3D printed model aided in navigating procedural challenges.
• The patient experienced significant symptomatic improvement post-procedure.

Implications:

• This case highlights the first use of the Mi-thos system for TMViR.
• The Mi-thos system, combined with 3D printing, shows feasibility and safety for recurrent MR after failed annuloplasty rings.
• This approach may offer a viable alternative to high-risk reoperations for selected patients.