AUTHOR=Lu Yuntao , Yang Ye , Wang Wenshuo , Chen Jinmiao , Yin Minyan , Huang Liqi , Dong Lili , Wang Chunsheng , Wei Lai 

TITLE=Transcatheter Mitral Valve-in-Valve Implantation With a New Transcatheter Heart Valve for Bioprosthetic Degeneration

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.783507

DOI=10.3389/fcvm.2021.783507

ISSN=2297-055X

ABSTRACT=Background: Transcatheter mitral valve-in-valve (TMVIV) procedure with aortic transcatheter heart valves has recently become a less invasive alternative for patients with mitral bioprosthetic dysfunction. This study reports the initial experience of TMVIV implantation using the J-Valve system (JieCheng Medical Technology Co, Ltd, Suzhou, China).
Methods: A retrospective observational multicenter study was conducted to evaluate the short-term outcomes of TMVIV. Totally, 26 consecutive patients with symptomatic bioprosthetic failure performed TMVIV using the J-Valve system at 8 hospitals between May 2019 and June 2021. Procedural results and clinical outcomes were analyzed using Mitral Valve Academic Research Consortium criteria.
Results: Mean age was 75.3±7.1years, 69.2% female, and Society of Thoracic Surgeons-Predicted Risk of Mortality score 12.3±8.3%. Transapical implantation was successful in 25 patients (96.2%). Nine patients (34.6%) were implanted the J-Valve of which the sizes were equal to internal diameters of deteriorated prostheses. At 30-day and 1-year follow-up, all-cause mortality was 3.8% and 16.0%, and stroke rate was 0% and 12.0%, respectively. Device-related mortality was 0%, and mean mitral valve gradient was 6.4±2.7 mmHg. No patient encountered device embolization, left ventricular outflow tract obstruction, device thrombosis and mitral valve reintervention. Postprocedural mitral regurgitation was none or trace in all patients. All patients were in NYHA class ≤II at the last follow-up.
Conclusion: Transcatheter implantation of the J-Valve system in high-risk patients with mitral bioprosthetic dysfunction was a reasonable alternative and associated with good short-term outcomes.