Valve-in-valve methodologies in transcatheter atrioventricular re-replacement using balloon-expandable prostheses: a series of clinical cases
Year: 2026
Type: article
Study design: Case Report
Abstract: Introduction: Given the annual increase in the need for repeated heart valve replacement, which is a high-risk surgical procedure due to repeated surgical access against the background of severe adhesions, trauma and comorbidity of patients, the technique of transcatheter heart valve replacement is becoming increasingly relevant and preferable. Objective: To present in detail modern methodologies for transcatheter mitral and tricuspid valve replacement using clinical examples. Methods: The presented patients had dysfunction of a previously openly implanted mitral/tricuspid bioprosthesis according to clinical data and echocardiography. Taking into account the high risk of surgical intervention, resternotomy and comorbid condition, after analyzing multispiral computed tomography within the framework of the cardiac team (cardiologist, endovascular surgeon, cardiovascular surgeon) it was decided to perform endovascular transcatheter repeat replacement using the "valve-in-valve" method. In both cases, puncture vascular access through the common femoral vein was used. Results: Balloon-expandable heart valve prostheses were effectively implanted in patients in the atrioventricular positions, achieving satisfactory hemodynamic parameters. Local anesthesia and transthoracic echocardiography were used for transcatheter tricuspid valve replacement. Mitral valve replacement was performed under total intravenous anesthesia, artificial ventilation, using transesophageal echocardiography, ultra-frequent cardiac pacing, and puncture of the interatrial septum. No complications were detected in the intra- and postoperative periods. The patients were discharged on the seventh day after the intervention. Conclusion: The methodology of transcatheter atrioventricular heart valve replacement is presented using clinical cases as an example, the effectiveness and safety of endovascular mitral and tricuspid valve replacement using balloon-expandable prostheses are shown. Further studies are needed that can provide a comparative assessment of the technologies of transcatheter and surgical atrioventricular heart valve replacement based on the analysis of long-term surgical results. Received 29 April 2025. Revised 28 January 2026. Accepted 3 February 2026. Informed consent The patient's informed consent to use the records for medical purposes is obtained. Funding The study was carried out with financial support from the Ministry of Science and Higher Education of the Russian Federation as part of the research project "Endovascular and extracorporeal technologies for the prevention and treatment of structural heart pathology and critical conditions in cardiac surgery" (No. 0419-2026-0004). Conflict of interest The authors declare no conflict of interest. Contribution of the authors Conception and study design: R.S. Tarasov, V.I. Ganyukov Data collection and analysis: I.V. Ganyukov, A.I. Danilovich Statistical analysis: I.V. Ganyukov, A.I. Danilovich Drafting the article: I.V. Ganyukov Critical revision of the article: R.S. Tarasov, V.I. Ganyukov Final approval of the version to be published: all authors
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7202297357