title: Transseptal mitral valve replacement after transcatheter aortic valve implantation.
abstract: We report a case of mitral valve replacement in a patient who had previously undergone transcatheter aortic valve implantation. A transseptal approach was used to avoid displacing the aortic prosthesis. Because of the small mitral annulus, a bioprosthetic aortic valve was used in reverse position for mitral valve replacement. The procedure did not interfere with the existing prosthesis, and a follow-up echocardiogram showed that both prosthetic valves were functioning well.To the best of our knowledge, this is the first report of mitral valve replacement in a patient who had a preceding transcatheter aortic valve implantation. We believe that the transseptal approach is promising for mitral valve replacement in such patients. Moreover, using a bioprosthetic aortic valve in reverse position is an option for mitral valve replacement when the mitral annulus is too small for placement of a standard bioprosthetic mitral valve.
authors.affiliation: Georgetown University School of Medicine, Washington, DC 20007, USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Flannery
authors.forename: Robert C
authors.initials: RC
authors.lastname: Lowery
authors.forename: Xiumei
authors.initials: X
authors.lastname: Sun
authors.forename: Lowell
authors.initials: L
authors.lastname: Satler
authors.forename: Paul
authors.initials: P
authors.lastname: Corso
authors.forename: Augusto
authors.initials: A
authors.lastname: Pichard
authors.forename: Zuyue
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000295:instrumentation; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D016896:Treatment Outcome
keywords: Aged, 80 and over; aortic valve; bioprosthesis; calcinosis/complications; cardiac surgical procedures; heart atria/surgery; heart valve prosthesis implantation; mitral valve insufficiency/surgery