Wang Yiwei, Ma Yuliang, Liu Yang, Yang Jian
Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China.
Tie Yi High School International Curriculum Center, Xi'an, Shaanxi, China.
Catheter Cardiovasc Interv. 2025 Mar;105(4):855-860. doi: 10.1002/ccd.31405. Epub 2025 Jan 7.
Transcatheter mitral valve replacement (TMVR) may emerge as a surgical alternative for high-risk patients with severe mitral annular calcification (MAC), yet several questions remain to be addressed. We present the case of a 67-year-old high-risk female patient with severe MAC (MAC score = 8) and mitral stenosis (effective orifice area = 121.3 mm). To avoid conventional high-risk surgery, we opted to perform the TMVR using the novel Mi-thos system via the transapical approach. We utilized a patient-specific three-dimensional printed model derived by preprocedural computed tomography angiography data to assess the feasibility of the novel device and to guide the operation, mitigating potential challenges. The successful outcome of the guided procedure led to symptomatic improvement in the patient. This case represents the first experience with the novel Mi-thos system for TMVR in a patient with severe MAC. Guided by a patient-specific three-dimensional printed model, the dedicated transcatheter heart valve may be a feasible and safe option for high-risk patients with severe MAC.
经导管二尖瓣置换术（TMVR）可能会成为患有严重二尖瓣环钙化（MAC）的高危患者的一种手术替代方案，但仍有几个问题有待解决。我们报告了一例67岁的高危女性患者，她患有严重的MAC（MAC评分=8）和二尖瓣狭窄（有效瓣口面积=121.3平方毫米）。为避免传统的高风险手术，我们选择通过经心尖途径使用新型Mi-thos系统进行TMVR。我们利用术前计算机断层扫描血管造影数据生成的患者特异性三维打印模型来评估该新型装置的可行性并指导手术，从而减少潜在挑战。该引导手术的成功结果使患者的症状得到改善。此病例代表了首次在患有严重MAC的患者中使用新型Mi-thos系统进行TMVR的经验。在患者特异性三维打印模型的引导下，专用经导管心脏瓣膜对于患有严重MAC的高危患者可能是一种可行且安全的选择。
