title: On-pump fibrillating heart mitral valve replacement with the SAPIEN™ XT transcatheter heart valve.
abstract: In some high-risk patients, standard mitral valve replacement can represent a challenging procedure, requiring a risky extensive decalcification of the annulus. In particular, high-risk redo patients and patients with a previously implanted transcatheter aortic valve, who develop calcific mitral disease, would benefit from the development of new, minimally invasive, transcatheter or hybrid techniques for mitral valve replacement. In particular, mixing transcatheter valve therapies and well-established minimally invasive techniques for mitral replacement or repair can help in decreasing the surgical risk and the technical complexity. Thus, placing transcatheter, balloon-expandable Sapien™ XT stent-valves in calcified, degenerated mitral valves through a right thoracotomy, a left atriotomy and on an on-pump fibrillating heart, represents an attractive alternative to standard surgery in redo patients, in patients with concomitant transcatheter aortic stent-valves in place and in patients with a high-risk profile. We describe this hybrid technique in detail.
authors.affiliation: Department of Cardiac Surgery, University Hospital of Lausanne, Lausanne, Switzerland.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferrari
authors.forename: Lars
authors.initials: L
authors.lastname: Niclauss
authors.forename: Didier
authors.initials: D
authors.lastname: Locca
authors.forename: Carlo
authors.initials: C
authors.lastname: Marcucci
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D002315:Cardiopulmonary Bypass; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery
keywords: High-risk patients; Mitral valve replacement; Mitral valve stenosis; Transcatheter valve replacement