Valve-in-valve transcatheter transfemoral mitral valve implantation (ViV-TMVI): Characteristics and early results from a nationwide registry

• DOI: 10.33963/kp.a2023.0094
• Publication Date: 2023-07-04T12:38:08Z
• Authors: Zenon Huczek; Maciej Mazurek; Janusz Kochman; Paweł Kralisz; Dariusz Jagielak; Jerzy Sacha; Marek Frank; Radosław Targoński; Andrzej Walczak; Bartosz Rymuza; Kajetan Grodecki; Piotr Scisło; Szymon Jędrzejczyk; Jakub Jańczak; Piotr Pysz; Piotr Nikodem Rud...; Marcin Demkow; Adam Witkowski; Marek Grygier; Wojciech Wojakowski
• Keywords: Interquartile range; Mitral valve replacement

Background: Valve-in-valve transcatheter transfemoral mitral valve implantation (ViV-TMVI) is an emerging treatment alternative to reoperation in high-surgical risk patients with failed bioprostheses. Aim: We aimed describe the characteristics of ViV-TMVI and evaluate its 30-day outcomes Polish population. Methods: A nationwide registry was initiated collect data on all bioprosthesis undergoing Poland. This study presents results a clinical echocardiographic follow-up. Results: Overall, 27 procedures were performed 8 centers up May 2022 (85% from 2020 onwards). The mean (standard deviation [SD]) age 73 (11.6) years median (interquartile range [IQR]) Society Thoracic Surgeons score 5.3% (4.3%–14.3%). Mean (SD) time between surgical 8.2 (3.2) years. Failed Hancock II (29%) Perimount Magna (22%) bioprostheses most frequently treated. Mechanisms failure equally often pure regurgitation or stenosis (both 37%) mixed etiology 26%. Balloon-expandable Sapien 3/Ultra valves used but 1 patient. Technical success 96.3% (1 patient required additional prosthesis). transvalvular gradient reached 6.7 (2.2) mm Hg area 1.8 (0.4) cm2. None had moderate severe only 14.8% graded as mild. achieved device 92.6% (2 ≥10 Hg) procedural 85.6%. There no deaths, cerebrovascular events, need for surgery during Conclusions: In short-term follow-up, safe effective at high re-operation. Longer observations larger samples are warranted.