Five-Year Outcomes of Patients With Mitral Structural Valve Deterioration Treated With Transcatheter Valve in Valve Implantation – A Single Center Prospective Registry

Nili Schamroth Pravda*, Raffael Mishaev, Amos Levi, Guy Witberg, Yaron Shapira, Katia Orvin, Yeela Talmor Barkan, Ashraf Hamdan, Ram Sharoni, Leor Perl, Alexander Sagie, Hana Vaknin Assa, Ran Kornowski, Pablo Codner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The Valve-in-Valve (ViV) technique is an emerging alternative for the treatment of bioprosthetic structural valve deterioration (SVD) in the mitral position. We report on intermediate-term outcomes of patients with symptomatic SVD in the mitral position who were treated by transcatheter mitral valve-in-valve (TM-ViV) implantation during the years 2010–2019 in our center. Three main outcomes were examined during the follow-up period: NYHA functional class, TM-ViV hemodynamic data per echocardiography, and mortality. Our cohort consisted of 49 patients (mean age 77.4 ± 10.5 years, 65.3% female). The indications for TM-ViV were mainly for regurgitant pathology (77.6%). All 49 patients were treated with a balloon-expandable device. The procedure was performed via transapical access in 17 cases (34.7%) and transfemoral vein/trans-atrial septal puncture in 32 cases (65.3%). Mean follow-up was 4.4 ± 2.0 years. 98% and 91% of patients were in NYHA I/II at 1 and 5 years, respectively. Mitral regurgitation was ≥moderate in 86.3% of patients prior to the procedure and this decreased to 0% (p < 0.001) following the procedure and was maintained over 2 years follow-up. The mean trans-mitral valve gradients decreased from pre-procedural values of 10.1 ± 5.1 mmHg to 7.0 ± 2.4 mmHg at 1 month following the procedure (p = 0.03). Mortality at 1 year was 16% (95%, CI 5–26) and 35% (95%, CI 18–49) at 5 years. ViV in the mitral position offers an effective and durable treatment option for patients with SVD at high surgical risk.

Original languageEnglish
Article number883242
JournalFrontiers in Cardiovascular Medicine
Volume9
DOIs
StatePublished - 26 Apr 2022

Keywords

  • mitral valve
  • outcomes
  • structural valve deterioration
  • transcatheter
  • valve-in-valve

Fingerprint

Dive into the research topics of 'Five-Year Outcomes of Patients With Mitral Structural Valve Deterioration Treated With Transcatheter Valve in Valve Implantation – A Single Center Prospective Registry'. Together they form a unique fingerprint.

Cite this