title: Transcatheter valve-in-ring implantation after a failed surgical mitral repair using a transseptal approach and a veno-arterial loop for valve placement.
abstract: A failure of a mitral valve repair, which includes the implantation of a mitral annuloplasty ring in the majority of cases, is associated with relevant mortality. Surgery is considered as the standard treatment for these patients. For patients who have an unacceptable high peri-surgical risk a transcatheter valve-in-ring (TVIR) procedure might be an option. Isolated case reports and small case series report on the feasibility of a TVIR implantation in mitral position. We present a case where a 29-mm Edwards Sapien valve was placed in a 32-mm Carpentier Edwards ring. To our knowledge no valve has been implanted so far in this ring size and this is the first case where a veno-arterial loop was used as guide rail for valve implantation and helped considerably to position the valve properly.
authors.affiliation: University Hospital Rostock, Rostock, Germany; Cardiovascular Center Darmstadt, Darmstadt, Germany.
authors.forename: Nina C
authors.initials: NC
authors.lastname: Wunderlich
authors.forename: Stephan
authors.initials: S
authors.lastname: Kische
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ince
authors.forename: Ilkay
authors.initials: I
authors.lastname: Bozdağ-Turan
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed
keywords: failed mitral repair; percutaneous mitral intervention; transcatheter valve-in-ring procedure