Conclusion
Our series of 12 patients shows the feasibility of successfully performing transcatheter bioprosthetic MV in surgically implanted degenerated MV prostheses or severe native MV stenosis following a surgically implanted mitral annuloplasty ring in patients with thrombus present in the LAA and/or LA body. Utilization of both 2D and 3DTEE especially 3DTEE was essential in avoiding contact with the thrombus and preventing any embolic complications. Our number of cases is small, and a much larger study is needed to assess the safety and efficacy of this procedure in such patients.