Simultaneous transapical transcatheter aortic and mitral valve replacement in a high-risk patient with a previous mitral bioprosthesis  Adil H. Al Kindi,

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Simultaneous transapical transcatheter aortic and mitral valve replacement in a high-risk patient with a previous mitral bioprosthesis  Adil H. Al Kindi, MD, Khaled F. Salhab, MD, Samir Kapadia, MD, Eric E. Roselli, MD, Amar Krishnaswamy, MD, Andrew Grant, MD, Emin Murat Tuzcu, MD, Lars G. Svensson, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 144, Issue 3, Pages e90-e91 (September 2012) DOI: 10.1016/j.jtcvs.2012.05.041 Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Simultaneous transapical TAVR and valve-in-valve replacement of a failing bioprosthetic mitral valve. A, Intraoperative echocardiography showing severe bioprosthetic mitral stenosis (arrow, left atrial view). B, Mitral valve after Sapien (Edwards Lifesciences Corp, Irvine, Calif) valve-in-valve implantation. The Journal of Thoracic and Cardiovascular Surgery 2012 144, e90-e91DOI: (10.1016/j.jtcvs.2012.05.041) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Fluoroscopic view after deploying the aortic valve with the wire through the prosthetic mitral valve (inducated by asterisk) (left anterior oblique projection). B, Both valves in place (right anterior oblique projection). TAVR, Transcatheter aortic valve replacement; MV, mitral valve; ViV, valve-in-valve. The Journal of Thoracic and Cardiovascular Surgery 2012 144, e90-e91DOI: (10.1016/j.jtcvs.2012.05.041) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions