Outcomes of transcatheter transseptal mitral valve-in-valve replacement using Edward's SAPIEN 3 in high surgical risk patients-a multicenter study in China
10.3969/j.issn.1004-8812.2025.02.003
- VernacularTitle:Edward's SAPIEN 3瓣膜系统在接受经房间隔二尖瓣瓣中瓣置换术的外科手术高危患者中的效应评估:一项中国多中心研究
- Author:
Xiang CHEN
1
;
Bin WANG
;
Yi-wei XU
;
Xiao-ping PENG
;
Fan QIAO
;
Xiang-wen LIANG
;
Ke HAN
;
Xiao-fei JIANG
;
Xiang MA
;
Wen-yi YANG
;
Guo-sheng FU
;
Mao-long SU
;
Yan WANG
Author Information
1. 厦门大学附属心血管病医院心血管内科,福建厦门 361000
- Publication Type:Journal Article
- Keywords:
Transcatheter mitral valve replacement;
Valve-in-valve;
Mitral bioprosthetic degeneration;
High-risk patients
- From:
Chinese Journal of Interventional Cardiology
2025;33(2):79-86
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of valve-in-valve transcatheter mitral valve replacement(ViV-TMVR)in patients with bioprosthetic valve degeneration who are at high surgical risk.Methods This study is a multi-center,retrospective cohort analysis of 20 consecutive patients who underwent transseptal ViV-TMVR using the Edwards SAPIEN 3 transcatheter heart valve(THV).The primary endpoints include technical success and procedural success,both defined according to the Mitral Valve Academic Research Consortium(MVARC)criteria,as well as mortality and functional change assessed based on New York Heart Association(NYHA)classification at 30-days and six months post-procedure.Clinical follow-up assessments are conducted at 30-days and six months.Results From February 2021 to October 2022,a total of 20 patients with symptoms of bioprosthetic valve degeneration were enrolled across nine sites in China.The patients had a mean age of(73.5±5.5)years,with 85.0%being females and 70.0%classified as NYHA class Ⅲ/Ⅳ.The study achieved a 100.0%technical success rate and a 90.0%procedural success rate finally.All patients remained alive during the 30-day follow-up period.However,six months post-intervention,two patients(10.0%)were re-hospitalized due to heart failure,and sadly,one of them(5.0%)died.None of the patients reported any adverse events related to ViV-TMVR during the follow-up period.Notably,there was a significant improvement in NYHA class compared to baseline(P=0.0004)at six-month follow-ups.Conclusions The transseptal ViV-TMVR technique proved to be highly successful and was associated with significant improvement in NYHA class function.These findings strongly suggest that it serves as a safe and efficient treatment alternative for high-risk patients suffering from bioprosthetic valve degeneration.