Aortic Valve in the Mitral Position

We read with interest Dr. London’s review of the 5-yr follow-up after transcatheter repair of secondary mitral regurgitation from the New England Journal of Medicine which appeared in the “Science, Medicine, and the Anesthesiologist” feature of the October 2023 issue of Anesthesiology. Dr. London noted the study’s conclusion that patients who underwent mitral valve edge-to-edge repair for moderate-severe or severe mitral regurgitation experienced reduced hospitalizations and all-cause mortality at 5-yr follow-up when compared to medical therapy alone. We would like to clarify that the pictured prosthesis associated with the review appears to be of an explanted percutaneous self-expanding aortic valve prosthesis rather than an edge-to-edge mitral valve prosthesis. While catheter-based prosthetic aortic valves have been utilized for mitral valve insufficiency with a preexisting mitral valvuloplasty ring, they are not utilized in edge-to-edge repair. Shown in figure 1 is an edge-to-edge commonly utilized in these procedures. We realize this error likely represents an unintended mistake in image publishing but believe it still warrants clarification for the journal’s readership.