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The procedure

The procedure

If a bioprosthetic valve fails, another bioprosthetic valve can be placed within it using a catheter (tube). This is called transapical transcatheter mitral valve‑in‑valve implantation. The aim is to insert a new valve without the need for open heart surgery in people for whom this would carry a high risk.

In this procedure, the new valve is inserted through a catheter into the heart using a general anaesthetic. The catheter is inserted into the body through a cut in the skin of the chest and through a small hole in the bottom of the heart wall. The old valve opening is widened and the new one is placed inside the old one via the catheter. Imaging is used to help the surgeon position the new valve correctly. The catheter system is then removed and the cut in the chest is closed. Antibiotics to prevent infection and drugs to prevent blood clots are given before and during the procedure. Sometimes, a heart–lung machine is used during the procedure to temporarily take over from the heart.

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