Related Experiment Video
Updated: Sep 11, 2025

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
Interdisciplinary Periprocedural Management of Patients Undergoing Transapical TMVI with the Tendyne System: A
Cyril D Ferro1, Fabien Praz1, Nicolas Brugger1
1Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
Objectives:
Mitral regurgitation (MR) represents the most common valvular heart disease (VHD) in the Western world. While transcatheter mitral valve repair (M-TEER) is the leading interventional treatment for surgically high-risk patients, transcatheter mitral valve implantation (TMVI) is reserved for selected patients with unsuitable anatomy for M-TEER. This review aims to summarize our institutional experience with transapical TMVI using the Tendyne valve (Abbott Vascular, CA, USA), focusing on interdisciplinary preoperative, intraoperative, and postoperative management strategies.
Methods:
We conducted a narrative review of current literature on TMVI with the Tendyne system and integrated it with a comprehensive analysis of our interdisciplinary clinical experience. Data were collected regarding patient selection, imaging protocols, procedural techniques, and postoperative care.
Results:
Utilizing the Tendyne valve, TMVI addresses symptomatic moderate-to-severe or severe MR in patients unsuitable for conventional surgery or M-TEER. Successful outcomes require thorough patient selection, including assessment of mitral annular calcification, absence of intracardiac thrombus, low left ventricular outflow tract (LVOT) obstruction risk, and optimal annular sizing. Multimodal imaging, particularly transoesophageal echocardiography and cardiac computed tomography, is essential for procedural planning and execution. TMVI is performed under general anaesthesia with intraoperative transoesophageal guidance and haemodynamic monitoring to minimize complications such as LVOT obstruction, bleeding, and valve malposition. Postoperative management emphasizes haemodynamic stabilization, bleeding control, and surveillance for paravalvular leaks or device dysfunction.
Conclusions:
TMVI with the Tendyne valve provides a viable and effective treatment for selected patients with symptomatic relevant MR. Optimal outcomes are dependent on meticulous interdisciplinary collaboration, advanced imaging protocols, and comprehensive perioperative management.
Related Concept Videos
Mitral Stenosis III: Medical Management
Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy Care II: Procedure
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes:
Mitral Regurgitation III: Medical Management
Aortic Regurgitation III: Medical Management

