First-in-Human Experience With Transcatheter Mitral Valve-in-Valve Implantation During Left Ventricular Assist Device Placement.

Valvular disease is common in patients undergoing left ventricular assist device (LVAD) implantation. Concomitant valve surgery increases procedural complexity and cardiopulmonary bypass time and may lead to worse outcomes. Although mitral regurgitation is the most common mitral valve dysfunction in patients undergoing LVAD implantation, mitral stenosis (MS) is occasionally encountered. MS can lead to restricted LVAD flow; therefore, mitral valve replacement is considered to be reasonable in patients with hemodynamically significant MS undergoing LVAD implantation. We describe a successful transcatheter mitral valve replacement (TMVR) via a transapical approach with concomitant LVAD implantation in a patient with bioprosthetic MS.