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

• Published in: Cureus Vol. 16; no. 1; p. e52920
• Main Authors: Abdel Jawad, Mohammad, Munguti, Cyrus M, Abu Kar, Abdullah, Boppana, Venkata, Fanari, Zaher
• Format: Report
• Language: English
• Published: 01.01.2024
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.52920

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.