A Unique Case of Jena Valve TAVR Post-Transcatheter Mitral Valve in Valve Replacement

Abstract/Description

Severe aortic regurgitation presents unique technical challenges for transcatheter aortic valve replacement (TAVR) due to the absence of annular calcification and device malanchoring risks. These challenges are inherently heightened with previous valve replacements and cardiac procedures, especially in patients with prior mitral valve-in-valve (TMViV) procedures. This case report describes a high-risk patient with symptomatic severe aortic regurgitation following TMViV procedure for mitral regurgitation, managed with a transapical valve-in-valve implantation of the JenaValve for compassionate use. The JenaValve, a device specifically engineered for AR, demonstrated successful anchoring, elimination of significant regurgitation, and low paravalvular leak after the procedure. Post-procedural imaging revealed optimal valve function and preserved mitral bioprosthesis integrity. The patient was alive and in good clinical condition at 30 days of follow-up. This case report supports the feasibility and safety of transcatheter leaflet-capturing valve systems for the treatment of severe aortic regurgitation in complex multivalve settings, where surgery carries prohibitive risk. The case report highlights the need for further research to define long-term outcomes in this population.

Presenting Author Name/s

Bradley Eppinger, Aakash Chadive, Shirish Yasa

Faculty Advisor/Mentor

Matthew Summers

Faculty Advisor/Mentor Email

mrsumme1@sentara.com

Faculty Advisor/Mentor Department

Cardiology

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A Unique Case of Jena Valve TAVR Post-Transcatheter Mitral Valve in Valve Replacement

Severe aortic regurgitation presents unique technical challenges for transcatheter aortic valve replacement (TAVR) due to the absence of annular calcification and device malanchoring risks. These challenges are inherently heightened with previous valve replacements and cardiac procedures, especially in patients with prior mitral valve-in-valve (TMViV) procedures. This case report describes a high-risk patient with symptomatic severe aortic regurgitation following TMViV procedure for mitral regurgitation, managed with a transapical valve-in-valve implantation of the JenaValve for compassionate use. The JenaValve, a device specifically engineered for AR, demonstrated successful anchoring, elimination of significant regurgitation, and low paravalvular leak after the procedure. Post-procedural imaging revealed optimal valve function and preserved mitral bioprosthesis integrity. The patient was alive and in good clinical condition at 30 days of follow-up. This case report supports the feasibility and safety of transcatheter leaflet-capturing valve systems for the treatment of severe aortic regurgitation in complex multivalve settings, where surgery carries prohibitive risk. The case report highlights the need for further research to define long-term outcomes in this population.