Transseptal MViV for high-risk patients associated with 100% success rate after 1 year

Treating high-risk patients with transseptal mitral valve-in-valve (MViV) using the Sapien 3 aortic transcatheter heart valve (THV) is associated with promising one-year outcomes, according to new findings published in JACC: Cardiovascular Interventions.

The MITRAL early feasible study included a total of three arms. The MViV arm included 30 patients with a median age of 77.5 years old. While more than 63% of the patients were women, the group’s median Society of Thoracic Surgeons score was 9.4%. All patients had failed surgical mitral bioprostheses.

Overall, the authors found that transseptal MViV led to a technical success rate of 100%, a mortality rate of just 3.3% and minimal complications after one year. One death occurred; it was due to an airway obstruction after the patient swallowed too many pills at once 29 days after the procedure.

The team noted that prior studies focused on the safety of MViV procedures had ended with higher mortality rates and more complications. For the MITRAL study, however, all patients were treated with transseptal access and the patient selection process was more careful.

“Transseptal MViV may be considered the standard of care for high-risk patients with degenerated mitral bioprostheses who have favorable anatomy pending longer term results,” wrote lead author Mayra Guerrero, MD, of the department of cardiovascular medicine at Mayo Clinic in Rochester, Minnesota, and colleagues.

Guerrero et al. did emphasize that more information is needed on how MViV with the Sapien 3 aortic THV may affect low-risk patients.

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