{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T07:42:26Z","timestamp":1777189346532,"version":"3.51.4"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Transcatheter mitral valve-in-valve (TMViV) implantation is an alternative treatment to surgery for high-risk patients with degenerated bioprosthetic mitral valves. Some types of bioprostheses are fluoroscopically translucent, resulting in an \u2018invisible\u2019 target deployment area. In this study, we describe the feasibility and outcomes of this procedure using intraoperative fusion of transoesophageal echocardiography (TEE) and live fluoroscopy to facilitate valve deployment in cases of invisible bioprosthetic valves.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We reviewed all TMViV implantations at our centre from July 2014 to July 2019. Patient, procedure and outcome details were compared between those with a visible bioprosthesis (N\u2009=\u200922) to those with an invisible one (N\u2009=\u200912). Intra-operative TEE and live Fluoroscopy co-registration were used for real-time guidance for all invisible targets.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>All valve implantations were completed successfully in both groups without cardiovascular injury, valve migration or left ventricular outflow-tract obstruction. Technical success was 100% in both groups. One-year survival was 83% [95% confidence interval (CI) 70\u201396] for the entire cohort, with 79% (95% CI 63\u2013100) survival for the visible group and 92% (95% CI 77\u2013100) for the invisible group. Probability of 1-year survival free from mitral valve reintervention, significant valve dysfunction, stroke or myocardial infraction was 78% (95% CI 63\u201393) for all patients whereby the probability was 72% (95% CI 54\u201397) in the visible group and 80% (95% CI 59\u2013100) for the invisible group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The use of intraoperative TEE and live fluoroscopy image fusion facilitates accurate TMViV among patients with a fluoroscopically invisible target-landing zone.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivab001","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T16:56:07Z","timestamp":1610643367000},"page":"695-702","source":"Crossref","is-referenced-by-count":3,"title":["Real-time intraoperative co-registration of transesophageal echocardiography with fluoroscopy facilitates transcatheter mitral valve-in-valve implantation in cases of invisible degenerated bioprosthetic valves"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8030-9283","authenticated-orcid":false,"given":"Isaac","family":"Wamala","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany"},{"name":"Department of Cardiovascular Surgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2851-695X","authenticated-orcid":false,"given":"Axel","family":"Unbehaun","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany"},{"name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cardiology, German Heart Center Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Kukucka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesiology and Intensive Care Medicine, German Heart Center Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Eggert-Doktor","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anesthesiology and Intensive Care Medicine, German Heart Center Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semih","family":"Buz","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9089-8111","authenticated-orcid":false,"given":"Julia","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"S\u00fcndermann","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany"},{"name":"Department of Cardiovascular Surgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-8620","authenticated-orcid":false,"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany"},{"name":"Department of Cardiovascular Surgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"},{"name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, Berlin, Germany"},{"name":"Department of Health Sciences and Technology, ETH Z\u00fcrich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Kempfert","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany"},{"name":"Deutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"key":"2022031517063038100_ivab001-B1","article-title":"Structural durability in Carpentier Edwards Standard bioprosthesis in the mitral position: a 20-year 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