{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:36:59Z","timestamp":1781563019345,"version":"3.54.5"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Despite the improvement of surgical techniques for mitral valve (MV) repair in children, mitral valve replacement (MVR) is sometimes still necessary. MVR and redo-MVR continue to be burdened by early postoperative mortality and long-term morbidity with only about 75% of these patients being alive or transplant-free 10 years after the initial MVR. Although transcatheter MVR (TMVR) is a well-established intervention in high surgical risk adults, only a few pediatric valve-in-valve case reports have been published. The purpose of this study was to describe our initial experience with the off-label use of the Sapien S3 valve for TMVR in a highly selected pediatric patient population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We conducted a retrospective analysis of pediatric patients who underwent TMVR at Boston Children\u2019s Hospital between October 2018 and July 2020.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Eight consecutive high surgical risk pediatric patients (median age, 9 years; range, 8\u201315) underwent TMVR (7 as valve-in-valve, 1 in a native MV). Each patient previously underwent multiple MV surgeries or MVR (median 4, range 2\u20135) and was highly symptomatic (Ross functional class 3 or 4). The indication for TMVR was mitral stenosis in 4 patients, regurgitation in 1, and mixed disease in 3. TMVR was successful in each patient, effectively reduced the left atrium and pulmonary hypertension (\n              <jats:italic>P<\/jats:italic>\n              =0.012 and 0.043 respectively), and was carried out without significant complications.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>TMVR is an attractive alternative to MVR in high surgical risk patients. In this small series, TMVR was acutely effective and safe, with very encouraging early results.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.120.009996","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T09:17:53Z","timestamp":1615886273000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Acute and Short-Term Outcomes of Percutaneous Transcatheter Mitral Valve Replacement in Children"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-3658","authenticated-orcid":true,"given":"Nicola","family":"Maschietto","sequence":"first","affiliation":[{"name":"Department of Cardiology (N.M., A.P., D.P.), Boston Children\u2019s Hospital, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"Prakash","sequence":"additional","affiliation":[{"name":"Department of Cardiology (N.M., A.P., D.P.), Boston Children\u2019s Hospital, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"del Nido","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery (P.d.N.), Boston Children\u2019s Hospital, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Porras","sequence":"additional","affiliation":[{"name":"Department of Cardiology (N.M., A.P., D.P.), Boston Children\u2019s Hospital, 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