First successful transcatheter double valve replacement from a transapical access and nine-month follow-up

Abstract

Transcatheter double valve replacement can be performed through a transapical access. The key to success is thorough preoperative planning based on CT, not only for sizing, but also for estimating the anatomical relationship of the prostheses. However, late migration can be expected and may lead to LVOT obstruction.

Successful First-in-Man Concomitant Transapical Transcatheter Aortic and Mitral Valve Replacements for Severe Native Aortic and Mitral Valve Stenosis Using the Edwards Certitude Delivery System

“…These patients often have concomitant mitral stenosis with a high Wilkins score, barring them from mitral balloon valvuloplasty. The option of performing TMVR of native mitral stenosis at the same time as TAVR, although not previously studied, has been reported in two cases [5,6]. To the best of our knowledge, this is the first simultaneous TAVR and TMVR of native aortic and mitral valves stenoses utilizing a single transapical access with the Edwards Certitude delivery system.…”

“…In the Bauernschmitt case [5], valve migration was not noted before the patient died from malignancy 9 months after implantation. In the Elkharbotly case [6], the reported 6-month follow-up was…”

“…Results from a global registry show that TMVR, when performed in highly selected patients, results in significant adverse events [4]. Simultaneous TAVR and TMVR of stenotic native valves has only been reported in two cases [5,6]. Here, we report the first case of simultaneous TAVR and TMVR for severely stenotic native aortic and mitral valves in a high-risk patient using the Edwards Certitude transapical delivery system (Edwards Lifesciences, Irvine, CA, USA) ( Figure 1).…”

“…Salaun et al [7] speculated that starting with mitral valve implantation may result in obstruction of the aortic prosthesis. Bauernschmitt et al [5] chose to implant the mitral valve first due to the anatomical proximity and concern for compression of the smaller aortic valve while implanting the larger mitral prosthesis. In Elkharbotly's case [6], the aortic valve was placed first.…”

A systematic review of reported cases of combined transcatheter aortic and mitral valve interventions

“…A total of 1783 articles were screened and total of 37 studies met our inclusion/exclusion criteria. The details of study selection are summarized in Figure .…”