{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:24:48Z","timestamp":1777861488265,"version":"3.51.4"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T00:00:00Z","timestamp":1496102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The manuscript was not supported by external funding"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Transcatheter mitral valve replacement has been successfully performed with the use of aortic transcatheter heart valves in hundreds of patients worldwide with severe dysfunction of a degenerated mitral bioprosthesis and high surgical risk for repeat operation. The delivery approach in the vast majority of the mitral valve\u2010in\u2010valve procedures has been transapical. Although the transseptal approach may be more technically challenging, it is less invasive and may be preferred by patients. Data from case series and a large international registry suggest that patients treated with transseptal mitral valve\u2010in\u2010valve have faster recovery, more improvement in left ventricular ejection fraction and possibly lower mortality compared with patients treated with transapical approach. A prospective clinical trial, the MITRAL trial (Mitral Implantation of TRAnscatheter vaLves) is evaluating the safety and feasibility of transvenous transseptal mitral valve\u2010in\u2010valve. The experience from this trial has allowed us to improve our procedural approach. In anticipation of a wider adoption of the transseptal approach for mitral valve\u2010in\u2010valve, we describe our current method step\u2010by\u2010step from planning the procedure through postprocedural management. This is an evolving technique that has changed with experience and the transition to newer generation transcatheter heart valve devices. We discuss the use of cardiac computed tomography for planning the procedure including transseptal puncture and valve size selection, provide procedural and technical tips, and discuss postprocedural care.<\/jats:p>","DOI":"10.1002\/ccd.27128","type":"journal-article","created":{"date-parts":[[2017,5,30]],"date-time":"2017-05-30T11:39:47Z","timestamp":1496144387000},"source":"Crossref","is-referenced-by-count":35,"title":["Transseptal transcatheter mitral valve\u2010in\u2010valve: A step by step guide from preprocedural planning to postprocedural care"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9151-8096","authenticated-orcid":false,"given":"Mayra","family":"Guerrero","sequence":"first","affiliation":[{"name":"Division of Cardiology Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Salinger","sequence":"additional","affiliation":[{"name":"Division of Cardiology Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Pursnani","sequence":"additional","affiliation":[{"name":"Division of Cardiology Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Pearson","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Lampert","sequence":"additional","affiliation":[{"name":"Division of Cardiology Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Levisay","sequence":"additional","affiliation":[{"name":"Division of Cardiology Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyde","family":"Russell","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1066-4962","authenticated-orcid":false,"given":"Ted","family":"Feldman","sequence":"additional","affiliation":[{"name":"Division of Cardiology Evanston Hospital Evanston Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.058"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.07.026"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.02.041"},{"key":"e_1_2_11_5_1","article-title":"Transcatheter mitral valve\u2010in\u2010valve\/valve\u2010in\u2010ring implantations for degerative post surgical valves: Results from the global valve\u2010in\u2010valve registry","author":"Dvir D","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_11_6_1","article-title":"Transcatheter mitral valve\u2010in\u2010valve and valve\u2010in\u2010ring implantations","author":"Dvir D.","year":"2016","journal-title":"Data Transcatheter Cardiovasc Ther"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-16-00209"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV10SUA7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2012.11.002"},{"key":"e_1_2_11_10_1","first-page":"360","article-title":"Computed tomography assessment for transcatheter mitral valve interventions","volume":"57","author":"Narang A","year":"2016","journal-title":"J Cardiovasc Surg"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.09.768"},{"key":"e_1_2_11_12_1","unstructured":"GuerreroM SalingerM LevisayJ et al. 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