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Updated: Jun 7, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Clinical Outcomes of Transcatheter Mitral Valve-In-Valve and Valve-In-Ring Implantation: A Systematic Review and
Khi Yung Fong1,2, John Ming Yan Koh1, Lip Wei Saw1
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Background:
Transcatheter valve-in-valve (VIV) or valve-in-ring (VIR) therapies for degenerated mitral bioprosthetic valves and rings are still evolving. We aimed to characterize short- and long-term outcomes of these procedures.
Methods:
An electronic literature search was conducted to retrieve articles describing mitral VIV or VIR implantation with at least 10 patients. Meta-analysis of proportions was carried out for 30-day or in-hospital outcomes of mortality, stroke, major bleeding, transfusion, acute kidney injury, procedural success, valve embolization, paravalvular leak, pacemaker implantation, and hospital stay. Individual patient data meta-analysis using Kaplan-Meier curve reconstruction was used to estimate long-term mortality of VIV, VIR and redo surgical mitral valve replacement (SMVR).
Results:
We analyzed 34 studies (7047 patients). Pooled procedural success was 94.8% in VIV and 80.5% in VIR. Pooled short-term mortality and stroke risk was 6.4% and 1.9% respectively in VIV, 9.1% and 1.6% respectively in VIR, and 8.4% and 5.5% respectively in SMVR.
Conclusions:
This study provides prognostic information on clinical outcomes for redo SMVR and transcatheter mitral VIV and VIR implantation.
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