Transcatheter Mitral Valve in Valve Implantation as Alternative Procedure of Mitral REDO Surgery

Ales Mokracek, Julia Canadyova, Ladislav Pesl, Miroslav Sulda, Radim Frana

Hospital Ceske Budejovice, Ceske Budejovice, Czechia

Date, time and location: 2018.05.25 10:30, Exhibition area, 1st Floor. Zone – D

Abstract

Background: Standard on pump mitral valve REDO surgery is sometimes risky procedure. Promising possibility for high risk patient seems to be transcatheter, off pump, valve in valve implantation (TMVI).

Methods: From 2013 we implanted in our institution 9 transcatheter valves into failed mitral bioprosthesis, 7 times Sapien XT and 2 times Sapien 3. The mean time from first operation was 7,5 years. The cause of mitral valve bioprostheses failure was stenosis in 6 patients and valve regurgitation in 3 patients. All procedures were done during left minithoracothomy and transapical approach. Mean Log EUROScore was 31% (3,36-50,3%). Follow up is 3, 6, 12 month after surgery and yearly after.

Results: 1 patient died 23 days after surgery for reason of multiorgan failure. Rests of patients are alive. Follow up is 143 patients/months (2-44months). Mean transvalvar gradient is 4,7 torr. One patient was reexplored for bleeding, one patient had stroke, full normalization.

Conclusions: TMVI seems to be promising alternative for mitral REDO valve in valve surgery. Esp. for high risk patient give us well tolerated procedure with excellent early results. Longer follow up is necessary.