{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:45:24Z","timestamp":1791931524916,"version":"4.3.4"},"reference-count":24,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The vast majority of transcatheter valve-in-valve (ViV) mitral procedures have been reported with the SAPIEN family. We aimed to report the preliminary experience with the Myval balloon-expandable device in this setting. Methods: Multicenter retrospective study of high-risk surgical patients with mitral bioprosthesis degeneration undergoing transcatheter ViV implantation with Myval device. Results: A total of 11 patients from five institutions were gathered between 2019 and 2022 (age 68 \u00b1 7.8, 63% women). The peak and mean transvalvular gradients were 27 \u00b1 5 mmHg and 14.7 \u00b1 2.3 mmHg, respectively, and the predicted neo-left ventricular outflow tract (neo-LVOT) area was 183.4 \u00b1 56 mm2 (range: 171 to 221 mm2). The procedures were performed via transfemoral access in all cases (through echocardiography-guided transeptal puncture (81.8% transesophageal, 11.2% intracardiac)). Technical success was achieved in all cases, with no significant residual mitral stenosis in any of them (peak 7.2 \u00b1 2.7 and mean gradient 3.4 \u00b1 1.7 mmHg) and no complications during the procedure. There were no data of LVOT obstruction, migration, or paravalvular leak in any case. Mean hospital stay was 3 days, with one major vascular complication and no stroke. At 6-month follow-up, there was one case with suboptimal anticoagulation presenting an increase in the transmitral gradients (mean 15 mmHg) that normalized after optimization of the anticoagulation, but no other relevant events. Conclusions: Transseptal ViV mitral implantation with the balloon-expandable Myval device was feasible and safe avoiding redo surgery in high-risk patients with bioprosthesis degeneration.<\/jats:p>","DOI":"10.3390\/jcm11175210","type":"journal-article","created":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T20:52:51Z","timestamp":1662497571000},"page":"5210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Transcatheter Mitral Valve-in-Valve Implantation with the Balloon-Expandable Myval Device"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6682-6636","authenticated-orcid":false,"given":"Sara","family":"Blasco-Turri\u00f3n","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Serrador-Frutos","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"},{"name":"Centro de Investigaci\u00f3n en Red\u2014Enfermedades Cardiovasculares, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2849-815X","authenticated-orcid":false,"given":"John","family":"Jose","sequence":"additional","affiliation":[{"name":"Cardiology Unit 2, Christian Medical College Hospital Vellore, Vellore 632004, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunasekaran","family":"Sengotuvelu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Apollo Hospitals, Chennai 600006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok","family":"Seth","sequence":"additional","affiliation":[{"name":"Cardiology Department, Fortis Escorts Heart Institute, New Delhi 110025, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor G.","family":"Aldana","sequence":"additional","affiliation":[{"name":"Cardiology Department, Clinica Medicadiz, Ibagu\u00e9 730006, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"S\u00e1nchez-Luna","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Carlos","family":"Gonzalez-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6873-4869","authenticated-orcid":false,"given":"Mario","family":"Garc\u00eda-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"G\u00f3mez-Herrero","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8816-3143","authenticated-orcid":false,"given":"Cristhian","family":"Aristizabal","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0764-0839","authenticated-orcid":false,"given":"J. Alberto","family":"San Rom\u00e1n","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2311-4129","authenticated-orcid":false,"given":"Ignacio J.","family":"Amat-Santos","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Cl\u00ednico Universitario de Valladolid, 47003 Valladolid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.3389\/fcvm.2021.783507","article-title":"Transcatheter Mitral Valve-in-Valve Implantation with a New Transcatheter Heart Valve for Bioprosthetic Degeneration","volume":"8","author":"Lu","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/j.jcin.2021.02.027","article-title":"Prospective Evaluation of Transseptal TMVR for Failed Surgical Bioprostheses: MITRAL Trial Valve-in-Valve Arm 1-Year Outcomes","volume":"14","author":"Guerrero","year":"2021","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"ytac131","DOI":"10.1093\/ehjcr\/ytac131","article-title":"Two case reports of transcatheter valve-in-valve implantation of Sapien 3 and MyVal in degenerated biological tricuspid prosthesis valves","volume":"6","author":"Jensen","year":"2022","journal-title":"Eur. Heart J. Case Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"363","DOI":"10.33963\/KP.a2022.0013","article-title":"Transcatheter treatment tricuspid regurgitation by valve-in-ring implantation with a novel balloon-expandable Myval\u00ae THV","volume":"80","author":"Ayhan","year":"2022","journal-title":"Kardiologia Polska"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"363","DOI":"10.5152\/AnatolJCardiol.2021.159","article-title":"Tip-to-base LAMPOON to prevent left ventricular outflow tract obstruction in a valve-in-ring transcatheter mitral valve replacement: First LAMPOON procedure in Turkey and first LAMPOON case for transseptal Myval\u2122 implantation","volume":"25","author":"Isravilov","year":"2021","journal-title":"Anatol. J. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"421","DOI":"10.4244\/EIJ-D-19-00413","article-title":"First-in-human evaluation of a novel balloon-expandable transcatheter heart valve in patients with severe symptomatic native aortic stenosis: The MyVal-1 study","volume":"16","author":"Sharma","year":"2020","journal-title":"EuroIntervention"},{"key":"ref_7","first-page":"596","article-title":"Balloon-expandable Myval transcatheter aortic valve implantation. First experience in Spain","volume":"73","author":"Serrador","year":"2020","journal-title":"Rev. Espa\u00f1ola Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2018.06.004","article-title":"Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography","volume":"32","author":"Mitchell","year":"2019","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcmg.2018.12.003","article-title":"Computed Tomography Imaging in the Context of Transcatheter Aortic Valve Implantation (TAVI)\/Transcatheter Aortic Valve Replacement (TAVR): An Expert Consensus Document of the Society of Cardiovascular Computed Tomography","volume":"12","author":"Blanke","year":"2019","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_10","unstructured":"Shalaka, B., Melina, C., Kiahltone, R.T., Vratika, A., Kristin, L., Michael, M., Martin, L., and Thomas, M. (2021, December 15). Mitral Valve in Valve App [Internet]. Available online: https:\/\/mplsheart.org\/valve-in-valve-digital-application."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"113","DOI":"10.21037\/acs-2020-mv-104","article-title":"A step-by-step guide to transseptal valve-in-valve transcatheter mitral valve replacement","volume":"10","author":"Harloff","year":"2021","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"585","DOI":"10.21037\/acs-2021-tviv-80","article-title":"Current state of transcatheter mitral valve implantation in bioprosthetic mitral valve and in mitral ring as a treatment approach for failed mitral prosthesis","volume":"10","author":"Agarwal","year":"2021","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.1093\/eurheartj\/suab083","article-title":"Aortic and mitral bioprosthetic valve dysfunction: Surgical or percutaneous solutions?","volume":"23","author":"Belluschi","year":"2021","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1136\/heartjnl-2017-312047","article-title":"Contemporary outcomes in reoperative mitral valve surgery","volume":"104","author":"Mehaffey","year":"2017","journal-title":"Heart"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur. Heart J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1161\/CIRCULATIONAHA.120.049088","article-title":"Transcatheter mitral valve replacement after surgical repair or replacement comprehensive midterm evaluation of valve-in-valve and valve-in-ring implantation from the VIVID registry","volume":"143","author":"Simonato","year":"2021","journal-title":"Circulation"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1001\/jamacardio.2020.2974","article-title":"One-Year Outcomes of Mitral Valve-in-Valve Using the SAPIEN 3 Transcatheter Heart Valve","volume":"5","author":"Whisenant","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_18","first-page":"E185","article-title":"Transseptal transcatheter mitral valve-in-valve: A step by step guide from preprocedural planning to postprocedural care","volume":"92","author":"Guerrero","year":"2017","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1002\/ccd.26309","article-title":"Mitral valve-in-valve with the lotus mechanically expanding platform","volume":"86","author":"Feldman","year":"2015","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_20","first-page":"725","article-title":"Early clinical and haemodynamic matched comparison of balloon-expandable valves","volume":"108","author":"Halim","year":"2021","journal-title":"Heart"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1093\/eurheartj\/ehy271","article-title":"Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: A 7-year experience","volume":"39","author":"Urena","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"401","DOI":"10.3389\/fcvm.2021.621258","article-title":"Transcatheter Mitral Valve Replacement and Thrombosis: A Review","volume":"8","author":"Ascione","year":"2021","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_23","unstructured":"(2021, December 16). Edwards Pauses Enrollment in Early Stage Mitral Program [Internet]. Available online: http:\/\/www.edwards.com\/fr\/newsroom\/Pages\/ShowPR.aspx?PageGuid=%7B61d40c10-d690-45fa-b541-ab1f4806b975%7D."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.jacc.2016.10.068","article-title":"Transcatheter Mitral Valve Replacement for Patients with Symptomatic Mitral Regurgitation: A Global Feasibility Trial","volume":"69","author":"Muller","year":"2017","journal-title":"J. Am. Coll Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5210\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:22:46Z","timestamp":1760142166000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/5210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,2]]},"references-count":24,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11175210"],"URL":"https:\/\/doi.org\/10.3390\/jcm11175210","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,2]]}}}