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Mitral clip

Felix Kreidel, Hannes Alessandrini, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
OBJECTIVE: To assess the results of catheter-based and surgical reintervention in primary mitral regurgitation (PMR) after failed MitraClip therapy. METHODS: We report on 21 consecutive symptomatic patients with PMR (median age 78 years) who underwent either repeat MitraClip therapy (n=7) or mitral valve surgery (n=14) after failure of the index procedure with 1-2 MitraClip implantations. At the time of reinterventions, 193 [IQR: 32 to 622] days after index procedure, patients had recurrent or persistent grade 3 MR...
March 12, 2018: Seminars in Thoracic and Cardiovascular Surgery
Charles B Nyman, G Burkhard Mackensen, Srdjan Jelacic, Stephen H Little, Thomas W Smith, Feroze Mahmood
Percutaneous intervention for mitral valve (MV) disease has been established as an alternative to open surgical MV repair in patients with prohibitive surgical risk. Multiple percutaneous approaches have been described and are in various stages of development. Edge-to-edge leaflet plication with the MitraClip (Abbott, Menlo Park, CA) is currently the only Food and Drug Administration-approved device specifically for primary or degenerative lesions. Use of the edge-to-edge clip for secondary mitral regurgitation is currently under investigation and may result in expanded indications...
February 23, 2018: Journal of the American Society of Echocardiography
Sang-Bae Ko
Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and neurosurgery (external carotid-internal carotid bypass surgery, carotid endarterectomy, or aneurysm clipping)...
February 2018: Korean Journal of Anesthesiology
Chad Kliger
No abstract text is available yet for this article.
February 2018: Journal of Interventional Cardiology
Stephanie El Hajj, Sheldon E Litwin
No abstract text is available yet for this article.
February 6, 2018: Journal of Cardiac Failure
Mathias Orban, Christian Besler, Daniel Braun, Michael Nabauer, Marion Zimmer, Martin Orban, Thilo Noack, Julinda Mehilli, Christian Hagl, Joerg Seeburger, Michael Borger, Axel Linke, Holger Thiele, Steffen Massberg, Joerg Ender, Philipp Lurz, Jörg Hausleiter
AIMS: Severe tricuspid regurgitation (TR) is common in patients with right-sided heart failure (HF) and causes substantial morbidity and mortality. Treatment options beyond medical therapy are limited for high-risk patients. Transcatheter edge-to-edge tricuspid valve (TV) repair showed procedural safety and short-term efficacy. Impact on mid-term outcome is unclear. This dual-centre observational study evaluates the mid-term safety, efficacy and clinical outcome after edge-to-edge TV repair for severe TR in patients with HF...
February 6, 2018: European Journal of Heart Failure
Gagan D Singh, Thomas W Smith, Walter D Boyd, Jason H Rogers
No abstract text is available yet for this article.
January 11, 2018: JACC. Cardiovascular Interventions
Jeremy J Thaden, Joseph F Malouf, Vuyisile T Nkomo, Sorin V Pislaru, David R Holmes, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge-to-edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip. METHODS AND RESULTS: Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics...
January 13, 2018: Journal of the American Heart Association
Daisuke Hachinohe, Azeem Latib, Eustachio Agricola, Antonio Colombo
Treatment for recurrent mitral regurgitation (MR) after MitraClip therapy remains a challenging issue. This study reports the efficacy of repeat MitraClip therapy for recurrent MR during the early phase after the index MitraClip procedure. We present a case series of four consecutive patients who underwent repeat MitraClip procedures for severe recurrent MR during the early phase. Partial clip detachment (PCD) was the suspected cause of recurrent MR in these cases. All patients received additional clip(s). PCD could be stabilized and MR grade improved in all cases compared with that before the second procedure...
December 27, 2017: Catheterization and Cardiovascular Interventions
Isaac Wamala, Mossab Saeed, Sunil J Ghelani, Kimberlee Gauvreau, Peter E Hammer, Nikolay V Vasilyev, Pedro J Del Nido
OBJECTIVES: During mitral valve repair using the foldoplasty technique, correct judgement of the necessary dimensions and orientation of the leaflet fold is a critical but challenging step that can affect the chances of successful repair. In this study, we investigated whether a leaflet plication clip can be used to guide suture foldoplasty for posterior leaflet prolapse of the mitral valve. METHODS: Complete posterior leaflet prolapse was created in both in vivo and ex vivo pig hearts by severing the chordae supporting the middle scallop...
December 6, 2017: European Journal of Cardio-thoracic Surgery
Yoshifumi Nakajima, Saibal Kar
The MitraClip (Abbott Vascular, Santa Clara, CA) procedure has emerged as a safe and effective treatment option for treatment of selected patients with severe mitral regurgitation (MR) who are at high risk for surgery. Effective reduction of MR is important to ensure an optimal clinical outcome. We present here the first case report of a significant commissural leak after a MitraClip procedure treated with a GORE CARDIOFORM Septal Occluder device (WL Gore & Associates, Flagstaff, AZ). CASE REPORT: An 81-year-old male presented with symptomatic recurrent MR following a MitraClip procedure using two clips...
December 8, 2017: Catheterization and Cardiovascular Interventions
Yuji Itabashi, Hiroto Utsunomiya, Shunsuke Kubo, Yukiko Mizutani, Hirotsugu Mihara, Mitsushige Murata, Robert J Siegel, Saibal Kar, Keiichi Fukuda, Takahiro Shiota
BACKGROUND: Postprocedural mitral stenosis (MS) is a main limitation for MitraClip™ (Abbot Vascular, Inc., Santa Clara, CA, USA) procedure. The purpose of this study was to detect the preprocedural predictors of high transmitral pressure gradient (TMPG) after MitraClip™ implantation, which indicated postprocedural mitral stenosis (MS). METHODS: We studied 79 patients who were implanted with MitraClip™ in our institute. Before the procedure, mitral valve orifice area (MVOA), and anterior-posterior (AP) and medial-lateral (ML) mitral annular diameters were measured at diastole using three-dimensional (3D) transesophageal echocardiography (TEE) data set...
April 2018: Journal of Cardiology
Mary Jacob, Hamid Shokoohi, Fabith Moideen, Amelia Pousson, Keith Boniface
Introduction: Focused training in transthoracic echocardiography enables emergency physicians (EPs) to accurately estimate the left ventricular function. This study aimed to evaluate the efficacy of a brief training program utilizing standardized echocardiography video clips in this regard. Methods: A before and after design was used to determine the efficacy of a 1 hour echocardiography training program using PowerPoint presentation and standardized echocardiography video clips illustrating normal and abnormal left ventricular ejection fraction (LVEF) as well as video clips emphasizing the measurement of mitral valve E-point septal separation (EPSS)...
2017: Emergency (Tehran, Iran)
Alec Vahanian, Marina Urena, Huseyin Ince, Georg Nickenig
The treatment of mitral regurgitation has changed in recent years due to the advent of interventional techniques, mostly the percutaneous edge-to-edge repair, and, more recently, annuloplasty and chordal replacement. In the future, more advances are expected from further development of interventional techniques, careful evaluation and better patient selection.
September 24, 2017: EuroIntervention
Rezo Jorbenadze, Johannes Patzelt, Meinrad Gawaz, Peter Seizer, Harald F Langer
Percutaneous edge-to-edge mitral valve repair (PMVR) is widely used for selected, high-risk patients with severe mitral valve regurgitation (MR). This report describes a case of 81-year-old woman presenting with severe and highly symptomatic mitral valve regurgitation (MR) caused by a flail of the posterior mitral valve leaflet (PML). PMVR turned out to be challenging in this patient because of a stenosis and tortuosity of both iliac veins as well as sclerosis of the interatrial septum, precluding the vascular and left atrial access by standard methods, respectively...
2017: Case Reports in Cardiology
Hsiu-Fen Huang, Hui-Yun Yu, Ching-Wei Lee, Hui-Chuang Chang, Mei-Ling Lin, Shin-Huey Wung
Open-heart surgery and conservative medical treatments have been the traditional, mainstay treatments for patients with severe mitral regurgitation (MR). Transcatheter edge-to-edge mitral repair is a novel technique. Using the transcatheter approach allows delivery of the clip into the left ventricle and the clipping of the orifice of the MR. The heart failure symptoms and outcomes of patients improve after this procedure. Compared to open-heart surgery, the mitral clip achieves similar MR reduction results with a significantly lower rate of complications...
August 2017: Hu Li za Zhi the Journal of Nursing
Xin Zhang, Steven M Hollenberg
Patients with valvular heart disease (VHD) should be treated for diabetes, hypertension, and hyperlipidemia. They also should receive therapy for left ventricular dysfunction, undergo interval echocardiography, and participate in aerobic exercise. Valve replacement should be considered for patients with aortic stenosis (AS) and syncope, presyncope, heart failure, angina, or severe AS with left ventricular dysfunction. Valve replacement is performed with open or transcatheter procedures; the latter are preferred for patients with high surgical risk...
June 2017: FP Essentials
Ilonka Rohm, Tudor C Poerner, Ali Hamadanchi, Sylvia Otto, Torsten Doenst, Christian Jung, P Christian Schulze, Björn Goebel
The objective of this study was to investigate the usefulness of intraprocedural hemodynamic monitoring for MR evaluation during pMRV. Assessment of mitral regurgitation (MR) during percutaneous mitral valve repair (pMVR) procedure is challenging. 3D color Doppler allows exact quantification of MR, but is technically demanding. Sixty patients with moderate to severe MR (14 with structural and 46 functional MR) were included in the study. Intraprocedural pressure curves were continuously obtained in the left atrium (LA) and left ventricle (LV)...
October 2017: International Journal of Cardiovascular Imaging
Z Rahhab, F A Kortlandt, J F Velu, R A J Schurer, V Delgado, P Tonino, A J Boven, B J L Van den Branden, A O Kraaijeveld, M Voskuil, J Hoorntje, M van Wely, K van Houwelingen, G B Bleeker, B Rensing, I Kardys, J Baan, J A S Van der Heyden, N M Van Mieghem
PURPOSE: Data on MitraClip procedural safety and efficacy in the Netherlands are scarce. We aim to provide an overview of the Dutch MitraClip experience. METHODS: We pooled anonymised demographic and procedural data of 1151 consecutive MitraClip patients, from 13 Dutch hospitals. Data was collected by product specialists in collaboration with local operators. Effect on mitral regurgitation was intra-procedurally assessed by transoesophageal echocardiography. Technical success and device success were defined according to modified definitions of the Mitral Valve Academic Research Consortium (MVARC)...
June 2017: Netherlands Heart Journal
Giuseppe D'Ancona, Stephan Kische, Jochen Senges, Taoufik Ouarrak, Miriam Puls, Raffi Bekeredjian, Horst Sievert, Erdal Safak, Jasmin Ortak, Alper Öner, Wolfgang Schillinger, Hüseyin Ince
AIMS: The aim of this study was to identify the impact of previous aortic valve replacement (AVR) in MitraClip (MC) patients. METHODS AND RESULTS: Data from the German transcatheter mitral valve interventions (TRAMI) registry were analysed in the light of previous AVR by means of either standard AVR (SAVR) or transcatheter AVR (TAVR). Out of 791 MC patients, 68 (8.6%) had been submitted to AVR (68.4% SAVR and 31.6% TAVR). The AVR group was significantly older (77...
July 20, 2017: EuroIntervention
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