Live Hemodynamics-Assisted Simultaneous Aortic and Mitral Valve-in-Valve Replacement
Related Experiment Video
Updated: Sep 13, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Siddhartha Mengi1, Dimitri Kalavrouziotis1, Pierre-Yves Turgeon1
1Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada.
Background:
Bioprosthetic valve failure is a growing challenge, particularly in high-risk patients who are poor surgical candidates. Simultaneous valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR) via a fully percutaneous approach remains a novel and evolving strategy with limited data.
Case Summary:
A 70-year-old man with failed aortic and mitral bioprostheses leading to severe intraprosthetic regurgitation presented with progressive heart failure symptoms. Owing to high surgical risk, he underwent transfemoral ViV-TAVR and transeptal ViV-TMVR using the SavvyWire for real-time hemodynamic monitoring and dedicated left ventricular pacing. The procedure was successful, with immediate hemodynamic improvement and no complications.
Discussion:
This case demonstrates the feasibility, safety, and efficiency of simultaneous transfemoral ViV-TAVR and ViV-TMVR in high-risk patients with bioprosthetic valve failure. Although further data are needed, this case highlights a novel application of the SavvyWire, demonstrating its potential to enhance procedural precision, enable real-time hemodynamic assessment, and improve safety in simultaneous ViV-TAVR and ViV-TMVR.
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