- Academic Editors
-
-
-
†These authors contributed equally.
Backgrounds: Percutaneous transseptal transcatheter mitral
valve-in-valve implantation (TMViV) has become an alternative minimally invasive
treatment choice for patients with degenerated mitral bioprosthesis and high
surgical risk. However, transseptal approach is more technically challenging than
transapical approach in TMViV procedures. Objective: The objective of
this study was to introduce the experience of applying long pre-curved sheaths in
transseptal TMViV procedures and to evaluate the effect of long pre-curved sheath
techniques in TMViV procedures. Methods: Between January 2020 and
December 2021, 27 patients with degenerated bioprosthetic mitral valve underwent
TMViV procedures using a balloon-expandable valve via the transseptal approach.
The regular 14/16F expandable sheath were used for low-profile delivery in first
10 cases, and 22F long pre-curved sheath were used in the next 17 cases during
procedures. We retrospectively reviewed the catheter techniques, perioperative
characteristics, and prognosis. The median follow-up time was 12 (1–21) months.
To further scrutinize our data, we divided the group into the early 10 patients
using 14/16F expandable sheath and the subsequent 17 patients with long
pre-curved sheath in order to assess the impact of different sheaths and
procedural details on outcomes. Results: Procedural success was obtained
in all patients with no in-hospital mortality. Seventeen patients received 26 mm
prostheses; the remaining ten patients received 29 mm prostheses. Post balloon
dilatation was performed in one case. Total procedure time was (96.1