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Mitral Valve-In-Valve ViV
Surgery in Hyderabad

What Is Mitral Valve-In-Valve Surgery?

Mitral valve-in-valve (MVIV) is performed for patients whose previously implanted tissue mitral valve has become damaged or has stopped working properly over time. The method provides therapy for a futile bioprosthetic mitral valve, mitral valve stenosis (narrowing of the valve), mitral valve regurgitation (leakage of the valve), structural valve degeneration, mitral valve calcification, and mixed mitral valve disease that involves both narrowing and leakage. These diseases might lead to signs like breathlessness, tiredness, palpitations, swelling in the legs, dizziness, and decreased physical activity.

Before doing a mitral valve-in-valve procedure, interventional cardiologists and cardiothoracic surgeons execute a detailed examination utilizing echocardiography, CT scans, and other cardiac evaluations to evaluate the condition of the valve and ascertain the most suitable treatment method. Developments in cardiac imaging and valve technologies have made mitral valve-in-valve treatment a vital therapy option for patients with failing mitral valves.

Types of Mitral Valve-in-Valve Procedures

Mitral valve-in-valve procedures are categorized based on the access route used to place the new valve. The choice of approach depends on the patient’s anatomy, overall health, and the condition of the existing valve, ensuring a safe and effective valve replacement.

• Transseptal Mitral Valve-In-Valve: In this minimally invasive procedure, the new replacement valve is delivered through a thin catheter inserted into a vein in the groin. The new valve is then positioned inside the failing bioprosthetic valve, restoring normal blood flow while avoiding the need for open-heart surgery in many patients.
• Transapical Mitral Valve-in-Valve: This approach involves implanting the new valve through a small incision made near the apex (tip) of the heart. The transapical technique may be recommended for patients whose anatomy or clinical condition makes the transseptal approach less suitable, offering an effective alternative for complex valve-replacement procedures.
• Hybrid Mitral Valve-In-Valve Procedure: This advanced approach combines surgical expertise with catheter-based technology to treat patients with complex mitral valve conditions. It allows specialists to customize treatment strategies, particularly in critical cases where conventional transcatheter procedures alone may not provide the best outcome.
• Surgical Mitral Valve Re-replacement (Redo Mitral Valve Surgery): Redo mitral valve surgery is a conventional open-heart procedure where the failed valve is removed and replaced with a new prosthetic valve. It helps restore optimal heart function and improve symptoms.
  These are the main methods used to treat a failed bioprosthetic mitral valve, with the option chosen based on the patient’s anatomy, valve condition, and overall health.