Transapical transcatheter valve-in-valve implantation treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement

Peijian WEI; Jian LIU; Nianjin XIE; Tong TAN; Jiexu MA; Zhao CHEN; Yanjun LIU; Hongxiang WU; Huanlei HUANG; Jimei CHEN; Jian ZHUANG; Huiming GUO

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Transapical transcatheter valve-in-valve implantation treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement

VernacularTitle:主动脉瓣及二尖瓣双瓣置换术后二尖瓣生物瓣衰败的经心尖经导管瓣中瓣治疗
Author: Peijian WEI ^{1
,

2} ; Jian LIU ³ ; Nianjin XIE ⁴ ; Tong TAN ^{1
,

2} ; Jiexu MA ^{1
,

2} ; Zhao CHEN ⁵ ; Yanjun LIU ⁵ ; Hongxiang WU ⁵ ; Huanlei HUANG ⁵ ; Jimei CHEN ⁵ ; Jian ZHUANG ⁵ ; Huiming GUO ⁵
Author Information

1. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China；
2. Shantou University Medical College, Shantou, 515041, Guangdong, P.R.China
3. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China
4. Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.China
5. Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, P.R.Chin
Publication Type:Journal Article
Keywords: Transapical transcatheter therapy; valve-in-valve; aortic-mitral double valve replacement; bioprosthesis deterioration
From: Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2021;28(08):901-907
CountryChina
Language:Chinese
Abstract: Objective To determine the clinical efficacy of transapical transcatheter mitral valve-in-valve treatment for patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement. Methods The clinical data of 9 patients who underwent transapical transcatheter mitral valve-in-valve implantation after aortic-mitral double valve replacement due to mitral bioprosthesis deterioration from May 2020 to January 2021 in our hospital were retrospectively analyzed, including 4 males and 5 females with a mean age of 72.44±7.57 years. Results Surgeries were performed successfully in all patients with no conversion to median sternotomy. The mean procedural time was 101.33±48.49 min, the mechanical ventilation time was 23.11±26.54 h, the ICU stay was 1.89±1.05 d and the postoperative hospital stay was 6.11±2.02 d. Residual mild mitral regurgitation was only observed in 1 patient. Only 1 patient needed postoperative blood transfusion. No major complications were observed in all patients. There was no death in postoperative 90 days. Conclusion For patients with deteriorated mitral bioprosthesis after aortic-mitral double valve replacement, transapical transcatheter mitral valve-in-valve implantation achieves good clinical results and effectively improves the hemodynamics without increasing the risk of postoperative left ventricular outflow tract obstruction. The surgery is feasible and effective.