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Combined Transcatheter Replacement of Aortic Root and Mitral Valve in an Acute Preclinical Study


The study aimed to evaluate the early feasibility of endovascular replacement of ascending aorta, aortic root (including aortic valve, AV), and mitral valve (MV) in one procedure with two self-expandable prostheses. Aortic valved-fenestrated-bifurcated (AVFB) and MV endografts of 10 healthy pigs (60–65kg) were customized and delivered through transapical and transseptal approach, respectively. Both endografts were successfully deployed in nine pigs (90%). Eight survived over 24 h, and the acute success rate was 80%. There was no significant increase in the mean trans-aortic, trans-mitral, and trans-LVOT pressure gradients after the operation. No coronary artery or LVOT obstruction and other electrocardiographic abnormality occurred. The transvalvular and paravalvular leak rates were low for both valves. Endovascular replacement of ascending aorta, AV, and MV in one procedure might be feasible.

Graphical Abstract

Combined transcatheter replacement of aortic root and mitral valve in one procedure

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The authors thank all of the animal experiment investigators.


This study was supported by the National Natural Science Foundation of China [81330034, 81770476, 81970208] and Shanghai Rising-Star Program [20QA1408900].

Author information




Conception and design (JZP, FJX, FR, ZJ), analysis and interpretation (ZZX, WMW, AA), data collection (ZYX, BXH, LTC, ZZX, WMW, AA), drafting the article (ZYX, LT, BXH, FJX), critical revision of the article (all authors), final approval of the article (all authors), and overall responsibility (JZP).

Corresponding authors

Correspondence to Jiaxuan Feng, Rui Feng or Zaiping Jing.

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Competing Interests

The authors declare no competing interests.

Human Studies

No human studies were carried out by the authors for this article.

Animal Studies

The care and use of laboratory animals were followed and approved by our Institutional Animal Care and Use Committee (protocol no. 2017-02002).

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Zhao, Y., Bao, X., Li, T. et al. Combined Transcatheter Replacement of Aortic Root and Mitral Valve in an Acute Preclinical Study. J. of Cardiovasc. Trans. Res. (2021).

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  • Aortic root
  • Aortic valve
  • Mitral valve
  • TAVR
  • TMVR