Journal article
Transcatheter Double Valve Replacement of an Aortic and Mitral Valve in the Native Annulus
Operative techniques in thoracic and cardiovascular surgery, Vol.23(4), pp.166-180
2018
DOI: 10.1053/j.optechstcvs.2019.04.001
Abstract
•This procedure is an alternative to surgical intervention in the high-risk or nonoperable patient.•Procedural success is improving and highly dependent on selecting the right candidate, with near circumferential annular calcification for valve anchoring and large LVOT that accommodates the valve stent and the anterior leaflet, neo-LVOT >189.4 mm2.•In contrast to surgical replacement, the aortic valve is replaced first prior to mitral valve replacement.•Preoperative cardiac gated CT scanning remains the most commonly used method for valve sizing and planning.•LVOT obstruction and valve embolization carry a substantial risk of morbidity and mortality but can be avoided with careful planning.•Alcohol septal ablation, possibly aided by percutaneous ventricular support devices, can help in the acute setting and can be an alternative to surgical bailout when LVOT obstruction occurs.
The role of percutaneous technology for aortic valve replacement therapy has been well established in the literature. However, transcatheter therapies for mitral valve disease are still in a very early phase. Successful transcatheter valve implantation in mitral valves with calcified annulae via different access sites has been reported. Most of the procedures that have been done are not well described or illustrated. We describe here the technique for performing a double transcatheter valve replacement in the native calcified aortic and mitral annulus utilizing a percutaneous transfemoral approach.
Details
- Title: Subtitle
- Transcatheter Double Valve Replacement of an Aortic and Mitral Valve in the Native Annulus
- Creators
- Firas Zahr - Oregon Health & Science UniversityOlivia Atari - University of IowaPhillip A. Horwitz - University of IowaMohammad Bashir - Division of Cardiothoracic Surgery, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA.
- Resource Type
- Journal article
- Publication Details
- Operative techniques in thoracic and cardiovascular surgery, Vol.23(4), pp.166-180
- Publisher
- Elsevier Inc
- DOI
- 10.1053/j.optechstcvs.2019.04.001
- ISSN
- 1522-2942
- eISSN
- 1532-8627
- Language
- English
- Date published
- 2018
- Academic Unit
- Cardiothoracic Surgery; Cardiovascular Medicine; Surgery; Internal Medicine
- Record Identifier
- 9984322904402771
Metrics
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