{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:51Z","timestamp":1753876251842,"version":"3.41.2"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Until now, dysfunctional mechanical valves had to be treated surgically. Motivated by in vitro fracture experiments and the first successful clinical implantation of a transcatheter valve (TAVR) into the remaining ring in aortic position, this approach was considered for the mitral position for the first time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 31-year-old female patient with a history of four open-heart surgeries and severe neurologic complications presented with cardiac decompensation due to a fixed tilt of her mechanical bileaflet mitral valve prosthesis, resulting in mitral stenosis with a mean gradient of above 10\u2005mmHg. An interventional approach was discussed. Using an apical access, the tilts were cracked under cerebral protection, and a balloon-implantable TAVR was implanted uneventfully. More than 3 years later, the patient is clinically stable, the valvular function is not impaired and the embolized fragment does not cause any problems in the distal abdominal aorta.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>To the best of our knowledge, this is the first case report that demonstrates the possibility to implant a biological TAVR in a failed bileaflet mechanical mitral valve after fracturing the carbon tilts.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf183","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T11:42:03Z","timestamp":1746790923000},"source":"Crossref","is-referenced-by-count":0,"title":["First successful transcatheter valve-in-valve implantation into a failed mechanical prosthetic mitral valve after fracturing the discs: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1604-8960","authenticated-orcid":false,"given":"Christian","family":"Butter","sequence":"first","affiliation":[{"name":"Department of Cardiology, Heart Centre Brandenburg Bernau and Faculty of Health Sciences Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane , 16321 Bernau\/Berlin, Ladeburger Stra\u00dfe 17 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Neuss","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Centre Brandenburg Bernau and Faculty of Health Sciences Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane , 16321 Bernau\/Berlin, Ladeburger Stra\u00dfe 17 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanja","family":"K\u00fccken","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Centre Brandenburg Bernau and Faculty of Health Sciences Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane , 16321 Bernau\/Berlin, Ladeburger Stra\u00dfe 17 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doreen","family":"Bensch","sequence":"additional","affiliation":[{"name":"Department of Radiology, Heart Centre Brandenburg Bernau , 16321 Bernau\/Berlin, Ladeburger Stra\u00dfe 17 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Erb","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Heart Centre Brandenburg Bernau, Brandenburg Medical School (MHB) Theodor Fontane , 16321 Bernau\/Berlin, Ladeburger Stra\u00dfe 17 ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"2025050907414343000_ytaf183-B1","doi-asserted-by":"crossref","first-page":"e010628","DOI":"10.1161\/CIRCINTERVENTIONS.121.010628","article-title":"Transcatheter mitral valve implantation: current status and future perspectives","volume":"14","author":"Russo","year":"2021","journal-title":"Circ Cardiovasc Interv"},{"key":"2025050907414343000_ytaf183-B2","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1016\/j.athoracsur.2015.04.062","article-title":"Contemporary outcomes of repeat aortic valve replacement: a benchmark for transcatheter valve-in-valve procedures","volume":"100","author":"Kaneko","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2025050907414343000_ytaf183-B3","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1016\/j.athoracsur.2013.07.019","article-title":"Acute obstruction by pannus in patients with aortic medtronic-hall valves: 30 years of experience","volume":"96","author":"Ellensen","year":"2013","journal-title":"Ann Thorac Surg"},{"key":"2025050907414343000_ytaf183-B4","doi-asserted-by":"crossref","first-page":"ytab130","DOI":"10.1093\/ehjcr\/ytab130","article-title":"First successful transcatheter valve-in-valve implantation into a failed mechanical prosthetic aortic valve facilitated by fracturing of the leaflets: a case report","volume":"5","author":"Butter","year":"2021","journal-title":"Eur Heart J Case Rep"},{"key":"2025050907414343000_ytaf183-B5","doi-asserted-by":"crossref","first-page":"528","DOI":"10.23736\/S0021-9509.19.11011-7","article-title":"The early days of vascular and heart valve prostheses: a historical review","volume":"61","author":"Basir","year":"2020","journal-title":"J Cardiovasc Surg"}],"container-title":["European Heart Journal - 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