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[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
PubMed

Insights

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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