case_images: PMC10644176_01
case_images: Fluoroscopic, CT volume-rendered, and multiplanar reformats CT images aligned with the THV illustrating the successive procedural steps with the initial MVIV (A), followed by redo-MVIV (B) and late valvuloplasty (C). The green line represents the mean diameter of the first (A) and second THV (B,C) in its mid-portion while the blue line illustrates the progressive flaring of the surgical heart valve (SHV) posts.
case_images: fcvm-10-1288278-g001.jpg
case_images: PMC10644176_01_fcvm-10-1288278-g001.jpg
case_images: F1
case_images: He had initially undergone coronary artery bypass graft surgery with mitral valve replacement (27 mm Mosaic, Medtronic, USA) in 2004, followed by transapical MVIV (26 mm SAPIEN XT, Edwards Lifesciences, USA; Figure 1A) in 2013 for surgical valve degeneration. In addition, the failed SAPIEN XT was found severely under-expanded (mid-portion at 19.5 mm, Figure 1A) without signs of valve thrombosis. THV (Figure 1B). The patient presented 1 month later with NYHA class III congestive heart failure symptoms and increased transvalvular MG (17 mmHg, HR 52 bpm). Interestingly, the CT scan also showed the overexpansion of the initial 27 mm Mosaic to almost 35 mm in diameter (Figure 1C).
case_images: Timeline of case presentation with interventions performed and evolution of MG on transthoracic echocardiogram. CABG, coronary artery bypass graft surgery; MVR, mitral valve replacement.
case_images: fcvm-10-1288278-g002.jpg
case_images: PMC10644176_01_fcvm-10-1288278-g002.jpg
case_images: F2
case_images: Figure 2 illustrates the procedural timeline and evolution of the transvalvular mitral MG.