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Concomitant Transapical Double Valve Replacement for Severe Native Mitral Regurgitation and Aortic Transcatheter
Hristian Hinkov1, Daniel Schwarzkopf2, Dustin Greve3
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Structural Heart Interventions Program, Deutsches Herzzentrum der Charité, Berlin, Germany; German Center for Cardiovascular Research, Partner Site Berlin, Berlin, Germany.
Background:
Transcatheter double valve replacement is an evolving strategy for managing combined mitral and aortic valve disease, particularly in patients with bioprosthetic valve degeneration.
Case Summary:
We report the case of an octogenarian with severe native mitral regurgitation and stenosis of a degenerated transcatheter aortic valve. Comorbid conditions, including extensive peripheral and coronary artery disease, limited conventional surgical and transcatheter access options. A tailored approach involving single-stage transapical implantation of a balloon-expandable aortic prosthesis and a dedicated mitral system resulted in favorable hemodynamic and clinical outcome.
Discussion:
This case represents the first published use of dedicated transcatheter mitral device in combination with transcatheter-valve-in-transcatheter-valve replacement. It underscores the potential of fully catheter-based double valve therapy in challenging scenarios.
Take-Home Messages:
Transapical transcatheter double valve replacement offers a viable alternative to redo surgery in select patients. Procedural success hinges on imaging-guided planning and individualized device strategy.
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