title: 'Fast-implantable' aortic valve implantation and concomitant mitral procedures.
abstract: Concomitant aortic and mitral valve replacement or concomitant aortic valve replacement and mitral repair can be a challenge for the cardiac surgeon: in particular, because of their structure and design, two bioprosthetic heart valves or an aortic valve prosthesis and a rigid mitral ring can interfere at the level of the mitroaortic junction. Therefore, when a mitral bioprosthesis or a rigid mitral ring is already in place and a surgical aortic valve replacement becomes necessary, or when older high-risk patients require concomitant mitral and aortic procedures, the new 'fast-implantable' aortic valve system (Intuity valve, Edwards Lifesciences, Irvine, CA, USA) can represent a smart alternative to standard aortic bioprosthesis. Unfortunately, this is still controversial (risk of interference). However, transcatheter aortic valve replacements have been performed in patients with previously implanted mitral valves or mitral rings. Interestingly, we learned that there is no interference (or not significant interference) among the standard valve and the stent valve. Consequently, we can assume that a fast-implantable valve can also be safely placed next to a biological mitral valve or next to a rigid mitral ring without risks of distortion, malpositioning, high gradient or paravalvular leak. This paper describes two cases: a concomitant Intuity aortic valve and bioprosthetic mitral valve implantation and a concomitant Intuity aortic valve and mitral ring implantation.
authors.affiliation: Cardiac Surgery Unit, Sion City Hospital, Sion, Switzerland Cardiac Surgery Unit, University of Lausanne, Lausanne, Switzerland enricoferrari@bluewin.ch.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferrari
authors.affiliation: Cardiac Surgery Unit, University of Lausanne, Lausanne, Switzerland.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Siniscalchi
authors.affiliation: Cardiac Surgery Unit, Sion City Hospital, Sion, Switzerland.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Marinakis
authors.affiliation: Cardiac Surgery Unit, University of Lausanne, Lausanne, Switzerland.
authors.forename: Denis
authors.initials: D
authors.lastname: Berdajs
authors.affiliation: Cardiovascular Research Unit, University of Lausanne, Lausanne, Switzerland.
authors.forename: Ludwig
authors.initials: L
authors.lastname: von Segesser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D023421:Models, Animal; D011474:Prosthesis Design; D013552:Swine; D016896:Treatment Outcome
keywords: Aortic and mitral valve replacement; Bio-prosthesis; Mitral valve repair; Redo cardiac surgery