INVASIVE INTERVENTIONS IN STRUCTURAL HEART DISEASES: COMPREHENSIVE TECHNIQUES

Invasive Interventions in Structural Heart Diseases-kapak

PERCUTANEOUS MITRAL VALVE-IN-VALVE AND VALVE-IN-RING 

Ahmet Karaduman

Koşuyolu Yüksek İhtisas Training and Research Hospital, Department of Cardiology, İstanbul, Türkiye

Karaduman A. Percutaneous Mitral Valve-in-Valve and Valve-in-Ring. In: Tanık VO, Özlek B, editors. Invasive Interventions in Structural Heart Diseases: Comprehensive Techniques. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.127-138.

ABSTRACT

Repeat mitral valve (MV) surgery is associated with increased perioperative risk and mortality, making less invasive alternatives an important option for high-risk patients. Transcatheter mitral valve replacement (TMVR) has emerged as a viable solution for patients with degenerated bioprosthetic valves or failed annuloplasty rings, utilizing valve-in-valve (MViV) and valve-in-ring (MViR) techniques. While MViV has shown higher procedural success due to the predictable structure of surgical bioprosthetic valves, MViR remains more complex due to the variability in annuloplasty ring design and anchoring challenges. Advancements in imaging, transseptal access, and device technology have improved outcomes, yet complications such as left ventricular outflow tract obstruction, paravalvular regurgitation, and valve thrombosis remain significant considerations. This chapter provides a comprehensive review of patient selection, procedural techniques, clinical outcomes, and future directions in TMVR, highlighting the evolving role of transcatheter approaches in mitral valve interventions.

Keywords: Left ventricular outflow tract obstruction; Mitral valve-in-valve; Mitral valve-in-ring transcatheter mitral valve replacement

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