27 Nov 2022
Mitral valve in mitral annular calcification (MAC) - Recorded case
Mitral stenosis with MAC: How to manage a complication and how to avoid it
Summary
A 53-year-old male with a history of SAVR (Perimount 23) 10 years ago and chest radiotherapy (lymphoma) presents a severe mitral stenosis (MAC) with preserved LV function and impaired RV function.
On sentinel cerebral protection, the operators perform a transseptal puncture with electrifying a non-stiff guide wire, and predilatation of the septal with an 18 mm balloon. Guiding by 3D CT fusion imaging, they implant a Sapien 3 on safary wire slowly on rapid pacing. Unfortunately, the first valve prolapse too much in the ventricle. They then implant a second Sapien 3 in the right place inside the previous one.
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Key moments
- 04:03 - 08:24 - Imaging analysis for mitral valve in valve
- 25:30 - 28:32 - Complication management
- 37:03 - 31:01 - Procedural analysis
- Experts discussion: how to explain the valve migration and how to avoid it.
Keywords: Mitral valve in MAC, Sapien 3, valve deployment complication, Sentinel-3D, CT fusion
