10 Oct 2025
Valve-in-valve in degenerated surgical bioprothesis mitral valve - LIVE Case
Operators:
I. Kuntjoro, J. Hon
Procedural Analyst:
P. Chiam
Summary
A 78-year-old male with a history of rheumatic disease underwent surgical mitral valve replacement (Perimount Magna 25), surgical aortic valve replacement (Perimount Magna), and CABG (LIMA–LAD) in 2010. He presented with symptomatic severe mitral regurgitation and normal LV function.
He was treated with implantation of a 26 mm Sapien 3 valve via transfemoral venous access and transseptal puncture under TEE guidance and general anesthesia, with cerebral protection using a Sentinel device.
LIVE Educational Case from National University Heart Centre - Singapore
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Key moments
- 05:40–08:48 – Imaging analysis
- 26:20–35:03 – Bioprosthesis crossing
- 36:03–42:30 – Septum dilatation
- 44:00–52:28 – Sapien 3 implantation
Keywords: Valve in valve in surgical bioprothesis mitral, Sentinel, Sapien 3
Learning Objectives
- To learn how to perform transcatheter mitral valve-in-valve procedure
- To understand the sizing of the valve for degenerated bioprosthetic valve
- To learn the transeptal and different steps in mitral valve-in-valve compared to standard TAVI procedure
