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Adham Elmously, MD, Berhane Worku, MD, Katherine D

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1 Mitral Valve-in-Valve Implantation as an Elective or Rescue Procedure in High-Risk Patients 
Adham Elmously, MD, Berhane Worku, MD, Katherine D. Gray, MD, Arash Salemi, MD  The Annals of Thoracic Surgery  Volume 105, Issue 6, Pages (June 2018) DOI: /j.athoracsur Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Intraoperative fluoroscopy demonstrating mitral valve-in-valve implantation. (A) Transcatheter heart valve positioning into a preexisting bioprosthetic valve using radiolucent markers through the transapical approach. (B) Balloon inflation of the transcatheter heart valve. (C) Transcatheter valve-in-valve prosthesis after deployment. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Transesophageal echocardiography demonstrating (A) a previous bioprosthetic mitral valve with evidence of severe regurgitation, and (B) postimplantation transapical mitral valve-in-valve function with nonobstructed flow (left) and trace regurgitation (right). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Box-and-whisker plot demonstrating transmitral gradient before (shaded) and after (open) transapical mitral valve-in-valve implantation (TA-MVIVI). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

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