Wang Yiwei, Mao Yu, Zhai Mengen, Ma Yanyan, Li Lanlan, Liu Yang, Yang Jian
Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.
J Cardiovasc Dev Dis. 2023 Aug 7;10(8):339. doi: 10.3390/jcdd10080339.
Transcatheter mitral valve-in-ring replacement (TMViR) is an emerging alternative for patients with recurrent mitral regurgitation (MR) after a prior failed annuloplasty ring. However, intraoperative common issues and complications remain to be addressed.
We describe the case of a 67-year-old male patient who underwent surgical mitral concomitant tricuspid annuloplasty repair 7 years ago who developed recurrent severe MR (New York Heart Association functional class IV). To avoid a high-risk surgical reoperation, we chose to perform a TMViR using an innovative dedicated device-the Mi-thos system-via a transapical approach. A patient-specific, 3-dimensional printed model was used to guide the procedure to avoid potential challenges. The procedure was performed successfully, and the patient exhibited symptomatic improvement.
This case report highlights the first use of the innovative Mi-thos system in a TMViR procedure. The findings demonstrate the feasibility and safety of utilizing the Mi-thos system, guided by 3-dimensional printing technology, for patients who have experienced recurrent mitral regurgitation MR following a failed annuloplasty ring.
经导管二尖瓣瓣环内置换术（TMViR）是一种针对先前瓣环成形术失败后出现复发性二尖瓣反流（MR）患者的新兴替代治疗方法。然而，术中常见问题及并发症仍有待解决。
我们描述了一名67岁男性患者的病例，该患者7年前接受了二尖瓣联合三尖瓣瓣环成形术修复，之后出现复发性严重MR（纽约心脏协会心功能IV级）。为避免高风险的再次手术，我们选择通过经心尖途径使用一种创新的专用装置——Mi-thos系统进行TMViR。使用定制的三维打印模型来指导手术，以避免潜在挑战。手术成功完成，患者症状改善。
本病例报告突出了创新的Mi-thos系统在TMViR手术中的首次应用。研究结果表明，对于瓣环成形术失败后出现复发性二尖瓣反流的患者，在三维打印技术引导下使用Mi-thos系统是可行且安全的。
