Transcatheter Mitral Valve-in-Valve Therapy.

Valve-in-valve and valve-in-ring transcatheter mitral valve replacement can be used in for the treatment of inoperable patients with failing mitral surgical bioprosthesis or valve repairs. Preprocedural multi-image evaluation by a heart team must include transthoracic echocardiogram, transesophageal echocardiogram, and cardiac computed tomography angiography (CTA). CTA is used to determine access site (transapical, transseptal, or transatrial), transcatheter valve size, and landing zone. Though complications can occur (ie, valve embolization, bleeding, or vascular complications), this less invasive procedure has a reported success rate of 70% to 100% and is now increasingly used.