1. Transapical Transcatheter Valve-in-Valve Implantation for Deteriorated Mitral Valve Bioprostheses 
Manuel Wilbring, MD, Konstantin Alexiou, MD, Sems Malte Tugtekin, MD, Bjoern Sill, MD, Peter Hammer, PhD, Torsten Schmidt, MD, Gregor Simonis, MD, Klaus Matschke, MD, Utz Kappert, MD 
The Annals of Thoracic Surgery 
Volume 95, Issue 1, Pages (January 2013)
DOI: /j.athoracsur
Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
Fluoroscopy sequence of transcatheter mitral valve-in-valve implantation in (A) a patient with prior aortic and mitral valve replacement. (B) The guidewire is placed through the mitral valve bioprosthesis and the Edwards SAPIEN valve subsequently delivered. After (C) slow and gradual expansion, (D) the SAPIEN valve is sufficiently anchored.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
Transesophageal echocardiography demonstrating implantation sequence of transcatheter mitral valve-in-valve implantation. (A) Two-dimensional echocardiography of the degenerated mitral valve bioprosthesis. The mechanism of failure was leaflet prolapse (*), (B) leading to severe regurgitation. After implantation of the SAPIEN valve, the prosthesis shows good anchorage with (C) full opening and (D) sufficient closure.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions