Results:

A cohort of 30 patients (age 75.6 ± 9.2 years; 25 men) with grade 3+ or 4+ MR underwent TMVR. MR etiology was secondary (n = 23), primary (n = 3), or mixed pathology (n = 4). The Society of Thoracic Surgeons Predicted Risk of Mortality was 7.3 ± 5.7%. Successful device implantation was achieved in 28 patients (93.3%). There were no acute deaths, strokes, or myocardial infarctions. One patient died 13 days after TMVR from hospital-acquired pneumonia. Prosthetic leaflet thrombosis was detected in one patient at follow-up and resolved after increased oral anticoagulation with warfarin. At 30 days, transthoracic echocardiography revealed mild (1+) central MR in one patient, and no residual MR in the remaining 26 patients with valves in situ. Left ventricular (LV) end-diastolic volume index and LV end-systolic volume index both decreased (90.1 ± 28.2 ml/m² at baseline vs. 72.1 ± 19.3 ml/m² at follow-up, p = 0.0012; and 48.4 ± 19.7 ml/m² at baseline vs. 43.1 ± 16.2 ml/m² at follow-up, p = 0.18; respectively). Seventy-five percent of the patients reported mild or no symptoms at follow-up (New York Heart Association functional class I or II). Successful device implantation free of cardiovascular mortality, stroke, and device malfunction at 30 days was 86.6%.