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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Stent With Occluder in the Valve Commissure Technique for Transcatheter Mitral Valve Replacement

Sidakpal S Panaich1, John Chen1, Santanu Biswas1

  • 1Swedish Heart & Vascular, Seattle, Washington, USA.

JACC. Case Reports
|July 18, 2025
PubMed

Insights

Transcatheter mitral valve replacement in patients with large mitral annular dimensions is challenging. A novel technique using a covered stent with an occluder successfully reduced annular size, facilitating a safe and effective procedure.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Device Innovation

Background:

  • Mitral annular calcification (MAC) causes progressive mitral valve dysfunction.
  • Transcatheter mitral valve replacement (TMVR) is used for high-risk patients.
  • Large mitral annular dimensions pose risks of valve migration and paravalvular leak (PVL).

Observation:

  • A prohibitive surgical risk patient presented with heart failure due to severe mitral stenosis and regurgitation.
  • Severe MAC and large mitral annular dimensions were confirmed.
  • Significant concerns existed regarding valve migration or PVL during TMVR.

Findings:

  • A novel technique utilized a covered stent with an occluder in the native valve commissure.
  • This approach successfully reduced the mitral valve annular area.
  • It facilitated a successful transcatheter mitral valve-in-MAC procedure.

Implications:

  • This technique addresses challenges in TMVR for patients with large mitral annuli.
  • It offers a potential solution to mitigate risks of valve migration and PVL.
  • This method may improve outcomes for high-risk patients undergoing TMVR.
Abstract

Keywords:
acute heart failuremitral valvevalve replacement

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