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Updated: Jun 9, 2026
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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
[Open Atrial Transcatheter Mitral Valve Replacement for Mitral Annular Calcification: First Case Report in Chile]
María Fernanda Abello1, Fernando Lucero2, Javier Garate2
1Universidad de Los Andes, Santiago, Chile.
Revista Medica De Chile
|June 8, 2026
Summary
Transcatheter mitral valve replacement via an open transatrial approach offers a viable alternative for patients with severe mitral annular calcification. This minimally invasive technique demonstrated feasibility in an elderly patient with high surgical risk.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Technology
Background:
- Severe mitral annular calcification poses significant challenges for valve replacement, especially in elderly patients with comorbidities.
- Conventional surgical methods carry high risks of morbidity and mortality in this patient population.
- Percutaneous and minimally invasive transatrial approaches are emerging as safer alternatives.
Purpose of the Study:
- To present the first reported case in Chile of transcatheter mitral valve replacement (TMVR) using an open transatrial approach.
- To describe the surgical technique and postoperative outcomes in a patient with severe mitral annular calcification and high surgical risk.
- To provide evidence for the feasibility of this minimally invasive technique in complex cases.
Main Methods:
- The study involved an 81-year-old woman with severe mitral stenosis and extensive mitral annular calcification.
- Transcatheter mitral valve replacement was performed via an open transatrial access.
- The technique allowed direct visualization, anterior leaflet resection, and precise prosthesis positioning.
Main Results:
- The transcatheter mitral valve replacement was successfully performed using the open transatrial approach.
- The procedure facilitated accurate prosthesis positioning, mitigating risks such as malposition, embolization, paravalvular leak, and left ventricular outflow tract obstruction.
- The patient experienced a favorable postoperative course up to hospital discharge.
Conclusions:
- Transcatheter mitral valve replacement via open transatrial access is a feasible and effective option for patients with severe mitral annular calcification and high surgical risk.
- This minimally invasive approach offers advantages over conventional surgery, including improved visualization and reduced complications.
- This case highlights the successful implementation of this advanced technique in Chile.
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