title: Direct transatrial transcatheter SAPIEN valve implantation through right minithoracotomy in a degenerated mitral bioprosthetic valve.
abstract: Transcatheter valve implantation into failing surgical mitral bioprosthetic valves have been reported. This strategy avoids performing high-risk repeat cardiac surgery in elderly patients with multiple comorbidities. All these patients have been treated by a transapical approach. We report a case of failing bioprosthetic mitral valve in an 82-year-old woman successfully treated with a 29-mm Edwards SAPIEN balloon expandable bioprosthesis (Edwards Lifesciences, Irvine, CA) with direct left atrial approach through a right anterior thoracotomy. Our experience demonstrates the technical feasibility and safety of this approach. Therefore, mitral valve-in-surgical valve implantation may be a viable treatment alternative in carefully selected patients.
authors.affiliation: Department of Cardiology and Cardiac Surgery, Niguarda Ca' Granda Hospital, Milan, Italy. giuseppe.bruschi@fastwebnet.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bruschi
authors.forename: Alberto
authors.initials: A
authors.lastname: Barosi
authors.forename: Paola
authors.initials: P
authors.lastname: Colombo
authors.forename: Luca
authors.initials: L
authors.lastname: Botta
authors.forename: Jacopo
authors.initials: J
authors.lastname: Oreglia
authors.forename: Federico
authors.initials: F
authors.lastname: De Marco
authors.forename: Roberto
authors.initials: R
authors.lastname: Paino
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
authors.forename: Luigi
authors.initials: L
authors.lastname: Martinelli
mesh_terms: D000369:Aged, 80 and over; D001705:Bioprosthesis / Q000009:adverse effects*; D006328:Cardiac Catheterization / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D013908:Thoracotomy / Q000379:methods*; D016896:Treatment Outcome