Implantação mitral transcateter valve‐in‐valve: papel pré‐procedimento da tomografia computadorizada com multidetetores

Reoperation after mitral valve surgery due to bioprosthesis dysfunction is associated with high morbidity and mortality. A possible alternative for patients at high surgical risk is transcatheter implantation of a prosthesis in reverse position using the valve-in-valve technique. Based on our experience with three cases of transcatheter double valve (aortic and mitral) implantation by a transapical approach, we describe the essential steps in preprocedural planning using multidetector computed tomography (MDCT). The first step is to identify the brand and size of the previously implanted bioprosthesis. The true internal diameter of this valve is then determined by MDCT (mean of major and minor axes, Figure 1), which is usually less than the labeled prosthesis size. The true internal diameter should be confirmed by referring to conversion tables or software apps such as ViV (Valve-In-Valve). The internal diameter between the stent posts of the bioprosthesis is