ArticleJACC. Case reports2026
Transseptal Transcatheter Balloon Expandable Valve-in-Valve-in-Ring Implantation in Mitral Position.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
10 authors.
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Abstract
backgroundThe durability of transcatheter mitral valve replacement (TMVR) using the Edwards Sapien valve in a mitral ring remains uncertain. This report details a complex transseptal valve-in-valve-in-ring procedure and discusses long-term outcomes. CASE SUMMARY: A 73-year-old man, with a history of coronary bypass surgery and mitral valve reconstruction, underwent valve-in-ring implantation with an Edwards Sapien 3 26-mm prosthesis 7 years ago. Now he presented with progressive dyspnea (NYHA functional class III) due to severe prosthetic valve degeneration. A transseptal valve-in-valve intervention was performed using an Edwards Sapien 3 Ultra Resilia 26-mm valve inside the degenerated Sapien 3 26-mm valve within a 30-mm Physio ring. DISCUSSION: Procedural challenges of valve-in-valve-in-ring interventions and their impact on TMVR longevity are reviewed, highlighting imaging guidance, transseptal puncture, and valve durability as key factors for long-term outcomes. TAKE-HOME MESSAGES: Transseptal valve-in-valve-in-ring implantation provides an alternative strategy for structural mitral valve deterioration. Long-term durability of TMVR requires continued assessment through dedicated registries and follow-up studies.
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