CTICasesAltaValve Transcatheter Mitral Valve Replacement
Imaging findings
CT in a patient with severe mitral stenosis shows an enlarged left atrium and heavy calcification that at first suggests mitral annular calcification but in fact involves the valve itself. A large bulbous device resembling a sphygmomanometer bulb occupies the left atrium: a self-expanding wire cage that extends across the annulus to form the new mitral valve. A septal occluder appears to sit behind the device, consistent with transseptal delivery.
Key takeaways
The AltaValve is a percutaneously placed mitral valve prosthesis whose distinguishing feature is that it requires no fixation to the annulus or subvalvular apparatus; the inflated atrial cage holds it in position, making it less aggressive than designs that clamp onto the ventricle. It is typically delivered transseptally, so an accompanying septal occluder may be present as part of the installation and should not be mistaken for a separate device or a complication. Recognizing unfamiliar percutaneous valve designs is increasingly necessary as more are implanted.
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