{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T16:13:35Z","timestamp":1765901615603,"version":"3.48.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transcatheter mitral valve replacement (TMVR) is emerging as a feasible alternative to conventional surgical intervention in patients at high surgical risk, also those with severe mitral annular calcification (MAC). However, the presence of a previously implanted self-expanding transcatheter aortic valve prosthesis introduces considerable technical difficulties, especially due to the risk of left ventricular outflow tract obstruction<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>To our knowledge, it is among the very few reported cases of combined percutaneous interventions with a self-expanding valve in the aortic position and a balloon-expandable valve in the mitral position. During the procedure, circulatory arrest occurred, followed by the development of cardiac tamponade; both complications were rapidly and effectively managed. Subsequently, the patient experienced acute heart failure caused by a residual, procedure-related defect in the atrial septum, which required closure via a percutaneous approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case underscores the significant technical and clinical challenges associated with TMVR in the setting of MAC, particularly in patients with a pre-existing self-expanding aortic bioprosthesis. Intra-procedural complications, including circulatory arrest, cardiac tamponade, and procedure-related atrial septal defect, required rapid treatment and solution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf629","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T13:10:07Z","timestamp":1764335407000},"source":"Crossref","is-referenced-by-count":0,"title":["Transcatheter mitral valve replacement in a complex mitral annular calcification anatomy"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2196-2941","authenticated-orcid":false,"given":"Fabrizio","family":"Tomai","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences, European Hospital and Aurelia Hospital , Via Portuense 700, 00148 Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"De Persio","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, European Hospital and Aurelia Hospital , Via Portuense 700, 00148 Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1837-5997","authenticated-orcid":false,"given":"Roberto","family":"Celotto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, European Hospital and Aurelia Hospital , Via Portuense 700, 00148 Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Migliaro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, European Hospital and Aurelia Hospital , Via Portuense 700, 00148 Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Salatino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, European Hospital and Aurelia Hospital , Via Portuense 700, 00148 Rome 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