Urgent Transcatheter Mitral Valve-in-Valve Replacement With Venoarterial Extracorporeal Membrane Oxygenation Support: Case Report and Review of the Literature

Critical mitral valve stenosis due to a failed bioprosthetic valve is associated with significant morbidity and mortality, with the transcatheter Valve-in-Valve (ViV) approach becoming a popular treatment option. We present a case of cardiogenic shock secondary to a stenotic mitral bio-prosthetic va...

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Published inCurēus (Palo Alto, CA) Vol. 16; no. 1; p. e52920
Main Authors Abdel Jawad, Mohammad, Munguti, Cyrus M, Abu Kar, Abdullah, Boppana, Venkata, Fanari, Zaher
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 25.01.2024
Cureus
Subjects
Blood pressure
Cardiac/Thoracic/Vascular Surgery
Cardiology
Case reports
Catheters
Disease
Ejection fraction
Extracorporeal membrane oxygenation
Heart
Hemodynamics
Hospitals
Medical imaging
Mitral valve stenosis
Mortality
Prostheses
Therapeutics
United States > US
mechanical circulatory support
failed bioprosthetic valves
cardiogenic shock
severe mitral stenosis
mitral valve-in-valve replacement
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Summary:Critical mitral valve stenosis due to a failed bioprosthetic valve is associated with significant morbidity and mortality, with the transcatheter Valve-in-Valve (ViV) approach becoming a popular treatment option. We present a case of cardiogenic shock secondary to a stenotic mitral bio-prosthetic valve. The Heart team was consulted; the patient was a high-risk surgical candidate for valve replacement. He required venoarterial extracorporeal membrane oxygenation as a bridge to definitive therapy. The patient underwent a successful urgent transcatheter mitral ViV procedure with a trans-septal approach. Follow-up echocardiography showed significant improvement in mitral valve dynamics. Recently emerging transcatheter approaches for mitral ViV implantation after balloon valvuloplasty into a failed mitral valve prosthesis are technically feasible in high-risk patient populations and should be considered over re-operative mitral valve surgery.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.52920