Current Indications for Transcatheter Mitral Valve Replacement Using Transcatheter Aortic Valves: Valve-in-Valve, Valve-in-Ring, and Valve-in-Mitral Annulus Calcification

Circulation. 2021 Jan 12;143(2):178-196. doi: 10.1161/CIRCULATIONAHA.120.048147. Epub 2021 Jan 11.

Abstract

Use of transcatheter mitral valve replacement (TMVR) using transcatheter aortic valves in clinical practice is limited to patients with failing bioprostheses and rings or mitral valve disease associated with severe mitral annulus calcification. Whereas the use of valve-in-valve TMVR appears to be a reasonable alternative to surgery in patients at high surgical risk, much less evidence supports valve-in-ring and valve-in-mitral annulus calcification interventions. Data on the results of TMVR in these settings are derived from small case series or voluntary registries. This review summarizes the current evidence on TMVR using transcatheter aortic valves in clinical practice from the characteristics of the TMVR candidates, screening process, performance of the procedure, and description of current results and future perspectives. TMVR using dedicated devices in native noncalcified mitral valve diseases is beyond the scope of the article.

Keywords: aortic valve; heart valve; mitral valve; surgery; transcatheter aortic valve replacement; transcatheter mitral valve replacement.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery*
  • Calcinosis / diagnostic imaging
  • Calcinosis / surgery*
  • Cardiac Catheterization / methods
  • Cardiac Catheterization / standards
  • Cardiac Catheterization / trends
  • Heart Valve Prosthesis / standards*
  • Heart Valve Prosthesis / trends
  • Heart Valve Prosthesis Implantation / methods
  • Heart Valve Prosthesis Implantation / standards*
  • Heart Valve Prosthesis Implantation / trends
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery*
  • Mitral Valve Annuloplasty / methods
  • Mitral Valve Annuloplasty / standards
  • Mitral Valve Annuloplasty / trends
  • Prosthesis Design / methods
  • Prosthesis Design / standards*
  • Prosthesis Design / trends