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Heart Lung Circ. 2015 Feb;24(2):e19-22. doi: 10.1016/j.hlc.2014.09.016. Epub 2014 Oct 5.

Transapical transcatheter valve-in-valve replacement for deteriorated mitral valve bioprosthesis without radio-opaque indicators: the "invisible" mitral valve bioprosthesis.

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Department of Invasive Cardiology, Humanitas Research Hospital, Rozzano (Milan), Italy. Electronic address:
Department of Invasive Cardiology, Humanitas Research Hospital, Rozzano (Milan), Italy.


In view of the high number of bioprosthetic valves implanted during the past 30 years, an increasing number of patients are coming to medical attention because of degenerated bioprostheses. Transcatheter aortic valve-in-valve implantation has been described as a less invasive alternative to re-operation to treat severe structural valve deterioration. As far as degenerated mitral valve bioprostheses are concerned, transcatheter transapical mitral valve-in-valve replacement (TMVR) has been less commonly performed, but may also become a viable alternative to re-do replacement surgery. We describe treatment of a degenerated bioprosthetic mitral valve, characterised by complete absence of any radio-opaque landmarks making the TMVR procedure very challenging.


Degenerated bioprosthesis; Radio-opaque bioprosthesis indicators; Severe mitral regurgitation; Transcatheter transapical mitral valve-in-valve replacement; Tridimensional transoesophageal echocardiography

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