Transcatheter Mitral Valve Implantation (TMVI) Using Edwards SAPIEN 3 Prostheses in Patients at Very High or Prohibitive Surgical Risk: A Single-Center Experience

Figure 3

TMVI-R: (a) fluoroscopy shows an Amplatz Super Stiff guidewire (Boston Scientific) inserted in the left ventricle through the 29 mm Duran Annuloplasty Ring after transseptal puncture. (b) Fluoroscopy shows balloon dilatation (Osypka VACS II 14 × 30 mm Balloon, Osypka AG, Germany; white arrow) of the interatrial septum to create an artificial atrial septum defect prior to insertion of the prosthesis into the left atrium. (c) Fluoroscopy shows the ES 3 prosthesis after insertion into the Duran Annuloplasty Ring prior to implantation. (d) Fluoroscopy shows the final result after implantation of the ES 3 prosthesis into the 29 mm Duran Annuloplasty Ring. (e) 3D-TEE shows the previously reconstructed mitral valve by 29 mm Duran Annuloplasty Ring prior to TMVI (view from left atrium). (f) 3D-TEE shows the insertion of the delivery catheter through the reconstructed mitral valve prior to implantation (view from lateral). (g) 3D-TEE showing the final result after implantation of the 29 mm ES 3 Prosthesis into the Duran Annuloplasty Ring (view from left atrium).

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