Valve-in-valve transcatheter mitral valve replacement via totally endoscopic endoclamp-assisted approach after failed bioprosthetic mitral valve: a case report.
- 1Department of Cardiac Surgery, Clinique du Millénaire, Montpellier, France. [email protected].
- 2Department of Cardiac Surgery, Clinique du Millénaire, Montpellier, France.
Abstract
Endoscopic Endoclampassisted MViV can expand the armamentarium for complex redo mitral surgery, offering excellent early clinical and haemodynamic results in selected patients. A 50 year-old man with heavy alcohol and tobacco use and two previous mitral operations (repair, then bioprosthetic replacement eight years earlier) presented with progressive dyspnoea (NYHA III). Transthoracic and transoesophageal echocardiography revealed severe mixed stenosis/regurgitation of a 33 mm Medtronic Mosaic bioprothesis. No endocarditis was found preoperatively. After shared decisionmaking, minimally invasive videoassisted right minithoracotomy under endoaortic balloon occlusion (Endoclamp®) was planned. Intraoperatively, the degenerated valve was firmly embedded in the native annulus and could not be safely explanted. A 29 mm SAPIEN 3 Ultra transcatheter heart valve was therefore deployed inside the surgical frame under direct vision on cardiopulmonary bypass (CPB). Postdeployment echocardiography showed a mean gradient of 8 mmHg without paravalvular leak or LVOT compromise. The patient was extubated on postoperative day 2; aside from temporary difficulties in respiratory weaning, recovery was uneventful, and he was discharged home on day 9.
Related
- Surgical aortic valve replacement-level aortotomy for self-expanding transcatheter aortic valve explantation
- Intravascular Ultrasound Guidance for Transcatheter Pulmonary Valve Replacement: A Feasibility Study.
- Clinical Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Pure Native Aortic Regurgitation: A Systematic Review and Meta-Analysis
- Longitudinal Trajectories of the Atherogenic Index of Plasma and Their Associations with Clinical Outcomes After Transcatheter Aortic Valve Replacement
- Coexisting Moderate-to-Severe Tricuspid Regurgitation and Renal Dysfunction Identify a High-Risk Group After Transcatheter Aortic Valve Replacement
BibTeX
@article{nader2026valveinvalve,
title = {{Valve-in-valve transcatheter mitral valve replacement via totally endoscopic endoclamp-assisted approach after failed bioprosthetic mitral valve: a case report.}},
author = {J Nader and A Roussiaux and J E Ricci and C Piot},
journal = {Journal of cardiothoracic surgery},
year = {2026},
month = jul,
doi = {10.1186/s13019-026-04080-2},
url = {https://europepmc.org/article/MED/42928280},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Valve-in-valve transcatheter mitral valve replacement via totally endoscopic endoclamp-assisted approach after failed bioprosthetic mitral valve: a case report.
AU - J Nader
AU - A Roussiaux
AU - J E Ricci
AU - C Piot
PY - 2026
DA - 2026/07/29
JO - Journal of cardiothoracic surgery
DO - 10.1186/s13019-026-04080-2
UR - https://europepmc.org/article/MED/42928280
AB - Endoscopic Endoclampassisted MViV can expand the armamentarium for complex redo mitral surgery, offering excellent early clinical and haemodynamic results in selected patients. A 50 year-old man with heavy alcohol and tobacco use and two previous mitral operations (repair, then bioprosthetic replacement eight years earlier) presented with progressive dyspnoea (NYHA III). Transthoracic and transoesophageal echocardiography revealed severe mixed stenosis/regurgitation of a 33 mm Medtronic Mosaic bioprothesis. No endocarditis was found preoperatively. After shared decisionmaking, minimally invasive videoassisted right minithoracotomy under endoaortic balloon occlusion (Endoclamp®) was planned. Intraoperatively, the degenerated valve was firmly embedded in the native annulus and could not be safely explanted. A 29 mm SAPIEN 3 Ultra transcatheter heart valve was therefore deployed inside the surgical frame under direct vision on cardiopulmonary bypass (CPB). Postdeployment echocardiography showed a mean gradient of 8 mmHg without paravalvular leak or LVOT compromise. The patient was extubated on postoperative day 2; aside from temporary difficulties in respiratory weaning, recovery was uneventful, and he was discharged home on day 9.
SN - 1749-8090
ER -