What Is Valve-in-Ring (TMViR)?
Many patients who;ve had earlier mitral valve repair surgery and received a surgical ring to support the repair. Over years, that repair can wear out or fail. TMViR places a new valve directly inside the existing ring through a catheter, rather than repeating open surgery.
How Is TMViR Performed?
A catheter is guided through a small incision, typically in the groin or chest wall
Using live imaging, the catheter is directed to the location of the existing surgical ring
A new valve is deployed precisely inside the ring
The new valve takes over normal valve function immediately
Who Needs Valve-in-Ring?
Patients with a prior surgical mitral valve repair (ring annuloplasty) that has degenerated
Patients for whom repeat open-heart surgery carries elevated risk
What Are the Risks?
Paravalvular leak around the new valve
Risk of left ventricular outflow tract obstruction (sometimes managed with the LAMPOON technique, if needed)
Bleeding, infection, or vascular access complications
Frequently Asked Questions
How is this different from a first-time TMVR?
TMViR is specifically for patients who already have a surgical ring in place from a previous repair; the new valve is placed inside that existing structure rather than a native, unoperated valve.
Does this avoid another open-heart surgery?
Yes — that;s the primary benefit. TMViR is designed specifically to treat a failed prior repair without repeating open-heart surgery.
About Dr. Abhishek Rajpopat
Dr. Abhishek Rajpopat brings 14+ years of experience in cardiology, including 750+ TAVR procedures performed globally. He specializes in advanced structural heart procedures and follows a patient-centered approach focused on complete, individualized care. His work has been recognized with multiple honors, including a Gold Medal in Cardiology. To discuss whether this procedure is right for you or a family member, visit www.drabhishekrajpopat.com.
