Clinical Outcomes Following Transcatheter Mitral Valve-in-Valve Replacement Using a Meril Myval Transcatheter Heart...

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomedical Engineering

Background:

• Degeneration of surgically implanted bioprosthetic mitral valves necessitates alternative treatment strategies.
• Transcatheter mitral valve-in-valve (TMViV) replacement offers a less invasive option for high-risk patients.
• The Myval transcatheter valve is frequently utilized for TMViV procedures in India.

Purpose of the Study:

• To evaluate the in-hospital, 30-day, and 1-year clinical outcomes of TMViV using the Myval device.
• To assess the safety and efficacy of TMViV in a cohort of Indian patients with degenerated bioprosthetic mitral valves.

Main Methods:

• Retrospective analysis of symptomatic patients (NYHA class III-IV) with degenerated surgical bioprosthetic mitral valves at high or very high risk for reoperation.
• Patients underwent TMViV using the balloon-expandable Myval transcatheter valve.
• Outcomes including technical success, valve gradients, complications, and mortality were assessed.

Main Results:

• Technical success was achieved in 100% of the 20 treated patients.
• Mean postprocedure and 30-day gradients were favorable, with no significant valvular or paravalvular leaks or left ventricular outflow tract obstruction.
• One-year all-cause mortality was 10%, with all survivors in NYHA class I or II.

Conclusions:

• Transcatheter mitral valve-in-valve replacement with the Meril Myval device is a safe and effective procedure.
• The Myval TMViV approach offers high technical success and low mortality at 30 days and 1 year.
• This indicates a promising therapeutic option for patients with degenerated bioprosthetic mitral valves in India.