Transcatheter mitral valve replacement for degenerated mitral bioprostheses: a systematic review

Mackram F. Eleid, Charanjit S. Rihal, Mayra Guerrero

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Treatment of degenerated mitral bioprostheses with transcatheter mitral valve-in-valve (MVIV) implantation is increasingly used. The goal of this review was to evaluate the one-year outcomes of this therapy using the most recent evidence. Methods: A MEDLINE, Cochrane database and SCOPUS search was performed of published observational studies involving patients undergoing transcatheter MVIV for degenerated bioprosthesis to determine procedural success, thirty-day and one-year survival. Results: A total of 2,684 patients undergoing transcatheter MVIV were identified from five studies with mean age of 73-75 years, 57-63% female and Society for Thoracic Surgery (STS) risk score ranging from 9-13%. Procedural technical success ranged from 94-98%, with 1-3% rates of periprocedural death, 0-2% stroke and 1-5% risk of left ventricular outflow tract (LVOT) obstruction. Thirty-day post-procedure mean mitral prosthetic gradient ranged from 6-7 mmHg and residual mitral regurgitation was mild or less in 96100% of patients. Thirty-day survival and one-year survival ranged from 93-97% and 83-89% respectively. Conclusions: Transcatheter MVIV is an effective treatment for structural degeneration of biologic mitral valve replacement with low complication rates and favorable one-year outcomes. Accordingly, MVIV should be considered as a reasonable alternative to re-do surgical mitral valve replacement in high risk patients with comorbidities. Further study of long-term outcomes of this treatment is needed.

Original languageEnglish (US)
Pages (from-to)558-563
Number of pages6
JournalAnnals of Cardiothoracic Surgery
Volume10
Issue number5
DOIs
StatePublished - Sep 2021

Keywords

  • mitral
  • Transcatheter
  • valve-in-valve

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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