Concomitant Transapical Double Valve Replacement for Severe Native Mitral Regurgitation and Aortic Transcatheter Valve Degeneration
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Published on: June 8, 2022
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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Aortic Regurgitation I: Introduction
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