Simultaneous transapical transcatheter aortic and mitral valve replacement in patients with severe valve dysfunction:...

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Medical Devices

Background:

• Simultaneous transcatheter mitral valve in valve (VIV) replacement and aortic valve replacement is an emerging procedure with limited documented experience.
• Severe aortic and mitral valve dysfunction often necessitates complex surgical interventions.

Purpose of the Study:

• To report the initial experience with simultaneous transapical transcatheter aortic valve replacement and mitral valve replacement.
• To evaluate the feasibility and safety of this combined approach using the self-expandable J-valve.

Main Methods:

• Eight patients with severe mitral bioprosthesis failure (VIV) and concurrent aortic valve disease underwent simultaneous transapical valve implantation.
• A self-expandable J-valve was used for both mitral and aortic valve replacement in all patients.
• Procedures were assessed for device success and complications according to Valve Academic Research Consortium-2 criteria.

Main Results:

• 100% device success was achieved, with no procedure-associated complications such as left ventricular outflow tract obstruction or valve migration.
• The mean length of hospital stay was 11.5 days, and there was no 30-day mortality.
• At a median follow-up of 28.7 months, all patients remained alive and in New York Heart Association functional classes I-II, with normofunctioning valves in both positions.

Conclusions:

• Simultaneous transapical transcatheter aortic and mitral valve replacement with the self-expandable J-valve is a feasible and effective alternative to conventional redo surgery.
• This combined approach offers a promising option for high-risk patients with severe, combined aortic and mitral valve disease.