Abstract
BackgroundTranscatheter 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 Corporation Ltd., Suzhou, China).MethodsA retrospective observational multicenter study was conducted to evaluate the short-term outcomes of TMVIV. In total, 26 consecutive patients with symptomatic bioprosthetic failure at eight hospitals underwent TMVIV using the J-Valve System between May 2019 and June 2021. Procedural results and clinical outcomes were analyzed using the Mitral Valve Academic Research Consortium criteria.ResultsThe mean age was 75.3 ± 7.1 years and 69.2% of patients were female. The mean Society of Thoracic Surgeons Predicted Risk of Mortality score was 12.3 ± 8.3%. The technical success rate was 96.2%. Nine of the 26 patients (34.6%) were implanted with a J-Valve of a size equal to the internal diameters of the deteriorated prostheses. At the 30-day and 1-year follow-ups, all-cause mortality was 3.8 and 16.0% and the stroke rates were 0 and 12.0%, respectively. Device-related mortality was 0% and the mean mitral valve gradient was 6.4 ± 2.7 mm Hg. No patient experienced device embolization, left ventricular outflow tract obstruction, or mitral valve reintervention. Postprocedural mitral regurgitation was none or trace in all the patients. All the patients were in the New York Heart Association (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 found to be a reasonable alternative and associated with good short-term outcomes.
Highlights
Mitral valve disease is the most prevalent form of valvular disease, affecting 10% of patients over the age of 75 years [1]
This study reports the initial experience of transcatheter mitral valve-in-valve (TMVIV) implantation using the J-Valve System (JieCheng Medical Technology Corporation Ltd., Suzhou, China)
Nine of the 26 patients (34.6%) were implanted with a J-Valve of a size equal to the internal diameters of the deteriorated prostheses
Summary
Mitral valve disease is the most prevalent form of valvular disease, affecting 10% of patients over the age of 75 years [1]. Bioprosthetic valves have become more common in the treatment of mitral valve disease. Structural valve deterioration is the most prevalent problem and reoperation is required in as many as 35% of patients within the first 10 years after mitral valve surgery [2]. Redo mitral valve surgery is associated with high perioperative morbidity and mortality [3, 4] due to repeat sternotomy, cardiopulmonary bypass, the older age of patients, and severe comorbidities. Transcatheter mitral valve-in-valve (TMVIV) implantation has been developed as a feasible and safe treatment for high-risk and inoperable patients [5,6,7]. This study reports the initial experience of TMVIV implantation using the J-Valve System (JieCheng Medical Technology Corporation Ltd., Suzhou, China)
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