Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
Catheter Cardiovasc Interv. 2019 Jan 1;93(1):E71-E74. doi: 10.1002/ccd.27658. Epub 2018 May 18.
Transcatheter mitral valve implantation (TMVI) has been performed in high-risk and inoperable patients for degenerated mitral bioprostheses (TMVIinV) and failed annuloplasty rings (TMVIinR). TMVIinR is more challenging compared to TMVIinV because of the differences in dimensions, shapes, and contours between rings and valves. In this report, we present two clinical cases of TMVIinR that were treated by trans-septal implantation of a balloon-expandable prosthesis. In TMVI cases with an incomplete ring, the ring will be stretched out toward its anterior and commissural side, and the open side of the ring will increase in width. The ring may not transform in line with the shape of the transcatheter heart valve (THV) and an interspace can develop between the THV and the ring at the commissural side, resulting in significant paravalvular regurgitation. Our experience suggests that the circumferential completeness of the rings may be an important factor to consider when planning a TMVIinR.
经导管二尖瓣植入术（TMVI）已在高危和不可手术的退行性二尖瓣生物瓣患者中进行（TMVIinV）和失败的瓣环成形环（TMVIinR）。与 TMVIinV 相比，TMVIinR 更具挑战性，因为环和瓣膜之间在尺寸、形状和轮廓上存在差异。在本报告中，我们介绍了两例经间隔植入球囊扩张假体治疗 TMVIinR 的临床病例。在不完全环的 TMVI 病例中，环将向其前和连合侧拉伸，并且环的开口侧将增加宽度。环可能不会与经导管心脏瓣膜（THV）的形状一致，并且在连合侧 THV 和环之间可能会出现间隙，导致严重的瓣周反流。我们的经验表明，在规划 TMVIinR 时，环的圆周完整性可能是一个重要的考虑因素。
