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You are here: Contents > 2015 > Volume 24 Number 3 May 2015 > AORTIC VALVE DISEASE > Concurrent Transcatheter Aortic Valve Implantation and Percutaneous Transvenous Mitral Commissurotomy for Totally Percutaneous Treatment of Combined Severe Rheumatic Aortic and Mitral Stenosis

Concurrent Transcatheter Aortic Valve Implantation and Percutaneous Transvenous Mitral Commissurotomy for Totally Percutaneous Treatment of Combined Severe Rheumatic Aortic and Mitral Stenosis

Mehmet Bilge1,2, Yakup Alsancak1, Sina Ali1, Ayse Saatci Yasar1

1Ataturk Education and Research Hospital, Division of Cardiology, Ankara, 2Yildirim Beyazit University, Faculty of Medicine, Division of Cardiology, Ankara, Turkey

Transcatheter aortic valve implantation (TAVI) is a new promising therapeutic option for patients with symptomatic severe calcific aortic valve stenosis (AS) who are inoperable or at high risk for conventional cardiac surgery. Percutaneous transvenous mitral commissurotomy (PTMC) is performed routinely in patients with severe mitral stenosis (MS) having a favorable anatomy. Although concurrent TAVI and PTMC is a theoretically possible approach in the treatment of patients with severe AS and MS who are unsuitable for conventional surgery, no cases have yet been reported in which this combined technique is used. For patients with severe AS and MS, the standard therapy is replacement of both the mitral and aortic valves. Herein are presented the details of a 52-year-old woman with urethral carcinoma, in whom simultaneous TAVI and PTMC was the chosen technique to treat combined severe rheumatic AS and MS in a single procedure.


Video 1: TEE (basal short-axis view) showing thickening and commissural fusion of the aortic valve with minimal calcification (right coronary cusp).

Video 2: TEE (long-axis view) showing stenotic aortic and mitral valves.

Video 3: TEE (long-axis view) showing the percutaneous transvenous mitral commissurotomy.

Video 4: The final aortography demonstrates no paravalvular leak.

Video 5: The CoreValve Revalving System, showing excellent function on echocardiography without aortic regurgitation.

Video 6: TEE (long-axis view) after percutaneous transvenous mitral commissurotomy and TAVI.

The Journal of Heart Valve Disease 2015;24:286-289

Concurrent Transcatheter Aortic Valve Implantation and Percutaneous Transvenous Mitral Commissurotomy for Totally Percutaneous Treatment of Combined Severe Rheumatic Aortic and Mitral Stenosis

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