Original Research
2021 Oct, 14 (20) 2195–2214
JOURNAL：J Am Coll Cardiol Intv.
Article Link
The Art of SAPIEN 3 Transcatheter Mitral Valve Replacement in Valve-in-Ring and Valve-in-Mitral-Annular-Calcification Procedures
VC Babaliaros, RJ Lederman, PT Gleason et al.
The SAPIEN 3 is the only transcatheter heart valve commercially
available for compassionate transcatheter mitral valve replacement in
patients with previous mitral surgical rings and mitral annular
calcification (valve in ring [VIR] and valve in mitral annular
calcification [VIM]). Reported outcomes have been inconsistent or poor.
The review provides an overview of the authors’ approach to achieve
largely consistent results despite the intrinsic limitations of SAPIEN 3
VIM and VIR. The approach includes bedside modifications of the valve
implant, the delivery system, and of the cardiac substrate itself. Until
purpose-built devices are readily available, VIR and VIM procedures
will require aggressive multidisciplinary cooperation, meticulous
planning and execution, and postprocedure management by experienced,
high-volume operators.
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