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

Figure 2

TMVI-VIV: (a) 3D-TEE shows degenerated biological mitral valve prosthesis (Carpentier Edwards 31 mm biological mitral valve prosthesis) with calcified and thickened leaflets (view from left atrium). (b) Fluoroscopy shows balloon dilatation (Osypka VACS II 12 × 40 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 left atrium. (d) Fluoroscopy shows the implantation of the ES 3 prosthesis into the malfunctioning biological mitral valve prosthesis. (e) Fluoroscopy shows the final result of the mitral valve-in-valve implantation.

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