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Invited Commentary
July 29, 2020

Transcatheter Mitral Valve-in-Valve—A Plausible Option but Questions Remain

Author Affiliations
  • 1Division of Cardiology, Montreal Heart Institute, Universite de Montreal, Montreal, Quebec, Canada
JAMA Cardiol. 2020;5(11):1253-1254. doi:10.1001/jamacardio.2020.2993

It is a mistake to look too far ahead. Only one link in the chain of destiny can be handled at a time.

Winston Churchill

Structural valve deterioration is a long-term complication of valve replacement and one that occurs more frequently with biologic valves. Reoperation for structural valve deterioration of a mitral prosthesis is associated with increased mortality, postoperative complications, and resource use.1 Transcatheter valve-in-valve replacement has shown promise in previously published series of fewer than 100 patients. It is therefore very interesting to review the data on outcomes of transcatheter mitral valve-in-valve (MViV) in high-risk patients from the Society of Thoracic Surgeons/American College of Cardiology TVT Registry published in this issue of JAMA Cardiology by Whisenant et al.2