Valvular & structural heart diseaseResearch article
Hemodynamic and Clinical Outcomes of Transcatheter Valve Expansion in Degenerated Mitral Bioprostheses
- retrospectively analyzed
- single-centre (Mayo Clinic Rochester)
- 2014–2023
Authors' conclusion
THV underexpansion in degenerated mitral bioprostheses is common and associated with elevated gradients and worse midterm outcomes. Further research is warranted to define THV expansion targets and improve outcomes following mitral valve-in-valve intervention.
Study context
- Population
- Patients who underwent mitral valve-in-valve with balloon-expandable valves for degenerated mitral bioprosthesesmedian follow-up of 2.5 years
- Participants
- 80 patients
- Comparison
- Transcatheter valve (THV) expansion and oversized vs recommended-size THVs
- Outcome
- Primary composite outcome of:
- All-cause mortality
- Heart failure readmission
- Valve reintervention
- Follow-up
- Median 2.5 years
Main finding
As reported in the abstract
Across all indices, THV expansion closer to nominal size was associated with lower rates of the primary outcome
P <0.05
Oversized THVs had a higher incidence of the primary composite outcome compared with recommended-size THVs
P =0.02
Further findings
THV underexpansion
- valves underexpanded across all 3 sizes
- 53 (66%)
- median inflow expansion index
- −10.2
- median waist expansion index
- −16.2
- median outflow expansion index
- −3.2
Mitral valve area and transvalvular mean gradient
- Greater expansion correlated with a larger mitral valve area and lower transvalvular mean gradient
Expansion by sizing
- Oversized THVs were significantly less expanded
Original publication
Hemodynamic and Clinical Outcomes of Transcatheter Valve Expansion in Degenerated Mitral Bioprostheses. Circ Cardiovasc Interv. Published 9 April 2026. doi:10.1161/circinterventions.125.016270
Summarised from the published abstract; every number is checked against it