ViV (Mitral)

An instant guide to Valve in Valve procedures for clinicians.

Valve In Valve (Mitral) Get it on Google Play

ViV (Mitral)

An instant guide to Valve in Valve procedures for clinicians.

Valve in Valve Mitral app was developed as a collaboration between the technology company UBQO and Dr. Vinayak (Vinnie) Bapat, Consultant Cardiac Surgeon at St. Thomas' Hospital, London, UK.

Valve in Valve Mitral app provides information specific for a clinical scenario, quickly and simply. This will help in the planning of and performing a mitral Valve in Valve or Valve in Ring case. The application navigates the user through important aspects of surgical mitral valves, mitral rings and TAVI valve design, which are vital for a successful Valve in Valve or ring procedure. The app logically steps through the possible combinations to give the user specific information needed to perform the procedure.

Success of a Valve in Valve or ring procedure is based on correct identification of the surgical valve or Ring, choosing the correct size of the TAVI valve and its subsequent accurate placement. Surgical valves and rings vary in appearance under fluoroscopy and also in their internal diameter. Similarly TAVI valves differ in their appearances and available sizes.

Knowledge about all the surgical valves and rings that have been implanted in the last two decades is minimal but relevant to the Valve in Valve or ring therapy. Users can now familiarize themselves with important design information about surgical valves, rings and TAVI valves; they can also select the valve and find out which size of TAVI valve could be used and how it is best placed during a Valve in Valve or ring procedure.

It also gives information about differences between TAVI valve sizing for mitral and aortic valve in valve procedure. Mitral ring properties, which will have a big implication when considering a valve in ring procedure are also discussed. It alerts the user about potential problems especially when considering valve in ring in certain designs.

The Valve In Valve Mitral app can be used to plan a case and confirm suitability for this procedure and reduces the need to trawl through vast amounts of literature to find information specific to the clinical scenario. The information is also available without the need for an internet connection and will enhance the users understanding of various aspects of this procedure. We hope this will result in improved results and better outcomes for patients.

At the heart of the idea is education that is free to use. It is hoped that the App will encourage users to contribute tips, tricks and feedback so that we can continue to develop the app.

Full list of features

Quick, clear and concise information about heart valves and rings and Valve in Valve therapy. A guide you wish you always had at your fingertips.

The App is not a substitute for clinical judgement or institutional policies, thus it should complement and not replace normal procedures for making clinical decisions.

We hope you enjoy using Valve in Valve!


The idea for the App came from the creative thinking of a teenager, Vinnie's daughter Shalaka Bapat. The idea was then pitched to the ever encouraging trio of Martyn Thomas, Michael Mack and Martin Leon. Prof. Michael Marber was instrumental in organising support from the NIHR Biomedical Research Centre to develop the App.

Supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London


Professional Support

The photographs, fluoroscopic images and movie clips were obtained with the help of Rizwan Attia, Alia Noorani, Shalina Sunni and Maya Guthrie, who worked tirelessly with the team for the last 3 months. We would like to thank:

We would like to thank:

Mark Monaghan, Martyn Thomas, Urmi Bapat and Martin Leon for providing encouragement and important testing feedback throughout the development of the App.

Cheska Farrarons for her help in preparing diagrams and colour scheme.

Anson Cheung, Bo Kelsjen and Franchesco Maisano for providing encouragement and examples at short notice.

The team at UBQO who led the team through the project process, from storyboard to AppStore App, in the face of very tight timescales.

Valve In Valve (Mitral) Get it on Google Play

Free to download


For iPhone, iPad & iPod Touch running iOS 6.0 or later.