One-year results of transcatheter implantation using the "valve-in-valve" technique for mitral valve degeneration

Objective . To evaluate the efficacy and safety of this method in patients with severe dysfunction of the mitral valve prosthesis. Materials and methods . From May 2015 to March 2024, 25 patients with mitral valve prosthesis failure due to degenerative changes were treated in the Department of Cardiovascular Surgery. The patients underwent transapical implantation of the prosthesis in the mitral position using the valve-in-valve technique using the Edwards Sapien XT (Edwards Lifesciences USA – California) and Myval (Meril Life Sciences, Vapi, India) valve systems via transfemoral access. Results .Implantation was successful in all cases, no conversion to open intervention was registered. Comparison of preoperative and postoperative echocardiographic parameters revealed a statistically significant decrease in the level of mean and maximum transprosthetic pressure gradients (12 [9.5; 16.2] versus 6 [4.7; 6] and 29.5 [22; 33.5] versus 12 [10; 14.75], respectively, p<0.0001), as well as the level of SPPA from 76 [62; 95] to 40 [35; 45] mmHg, p<0.0001 Conclusion . Transcatheter implantation in the mitral position using the "valvein-valve" technique for the treatment of patients with high surgical risk with degeneration of the mitral valve prosthesis is an effective and safe technique. An important stage in this intervention is careful preoperative planning with the selection of a prosthesis of the required size and assessment of an unfavorable clinical outcome depending on the anatomical features of the patient.