Moritz Seiffert et al. JCIN 2012;5:

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Moritz Seiffert et al. JCIN 2012;5:341-349 Ex Vivo Crimping and Mitral Valve-in-Valve Implantation For transapical mitral valve-in-valve implantation, the 26-mm Sapien XT valve (Edwards Lifesciences, Irvine, California) is crimped onto the delivery system in a reverse fashion when compared with transapical aortic valve implantation (A and B). The THV is positioned within the 27-mm Carpentier Edwards porcine (Edwards Lifesciences) mitral prosthesis and deployed to slightly overlap the sewing ring toward the left atrium for sufficient anchoring (C and D). Fluoroscopy demonstrates circular stent expansion and adequate approximation (E). Final results confirm appropriate geometry after mitral valve-in-valve implantation (F to H). Moritz Seiffert et al. JCIN 2012;5:341-349 American College of Cardiology Foundation