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The Art of SAPIEN 3 Transcatheter Mitral Valve Replacement in Valve-in-Ring and Valve-in-Mitral-Annular-Calcification Procedures Attenuated Mitral Leaflet Enlargement Contributes to Functional Mitral Regurgitation After Myocardial Infarction Adaptive development of concomitant secondary mitral and tricuspid regurgitation after transcatheter aortic valve replacement Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation: Outcomes at 2 years Incidence and Standardized Definitions of Mitral Valve Leaflet Adverse Events After Transcatheter Mitral Valve Repair: the EXPAND Study Thrombotic Risk and Antithrombotic Strategies After Transcatheter Mitral Valve Replacement Initial experience with percutaneous mitral valve repair in patients with cardiac amyloidosis Association Between Malignant Mitral Valve Prolapse and Sudden Cardiac Death: A Review Italian Society of Interventional Cardiology (GIse) Registry Of Transcatheter Treatment of Mitral Valve RegurgitaTiOn (GIOTTO): Impact of Valve Disease Etiology and Residual Mitral Regurgitation after MitraClip Implantation Pathophysiology, diagnosis and new therapeutic approaches for ischemic mitral regurgitation
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Original Research2021 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.

ABSTRACT

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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