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Mitraclip, percutaneous mitral valve

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https://www.readbyqxmd.com/read/29897008/interventional-echocardiography-of-the-mitral-valve-what-the-interventionist-wants-to-know
#1
Ludmil Mitrev, Nayan Desai, Ahmed Awad, Sajjad Sabir
The past 2 decades have seen a proliferation of transcatheter mitral valve (MV) therapies, which are less invasive and distinct from surgical MV repair or replacement. The commonly used MV transcatheter therapies include (1) percutaneous mitral balloon commissurotomy (PMBC) for rheumatic mitral stenosis; (2) edge-to-edge repair with the MitraClip for mitral regurgitation; (3) valve-in-valve implantation in bioprosthetic MV, native MV, or mitral ring; and (4) closure of paravalvular leaks (PVLs). This article will focus on the use of echocardiography in the diagnosis, patient selection, procedural guidance, and postprocedural follow-up for PMBC, with notes on the role of transesophageal echocardiography in transcatheter interventions for prosthetic valve degeneration and PVL closure...
June 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29896861/galectin-3-and-st2-as-predictors-of-therapeutic-success-in-high-risk-patients-undergoing-percutaneous-mitral-valve-repair-mitraclip
#2
Oliver Dörr, Claudia Walther, Christoph Liebetrau, Till Keller, Thomas Sommer, Niklas Boeder, Matthias Bayer, Pascal Bauer, Helge Möllmann, Luise Gaede, Christian Troidl, Sandra Voss, Timm Bauer, Christian W Hamm, Holger Nef
BACKGROUND: Percutaneous mitral valve repair (PMVR) is an interventional treatment option in patients with severe mitral regurgitation (MR) who have a high risk for open-heart surgery. Currently, there is limited information about predictors of procedural success after PMVR. Galectin-3 (Gal-3) and ST2 induce fibrotic alterations in severe MR and heart failure. The aim of the present study was to examine the predictive value of Gal-3 and ST2 as specific indicators of therapeutic success in high-risk patients undergoing PMVR...
June 12, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29860072/percutaneous-edge-to-edge-mitral-valve-repair-using-the-new-mitraclip-xtr-system
#3
Rezo Jorbenadze, Juergen Schreieck, Carola Barthel, Peter Seizer, Christian Schlensak, Meinrad Gawaz, Johannes Patzelt, Harald F Langer
No abstract text is available yet for this article.
May 24, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29791711/percutaneous-edge-to-edge-transcatheter-mitral-valve-repair-current-indications-and-future-perspectives
#4
Martino Pepe, Emanuela De Cillis, Tommaso Acquaviva, Annagrazia Cecere, Pasquale D'Alessandro, Arturo Giordano, Marco Matteo Ciccone, Alessandro Santo Bortone
Mitral regurgitation (MR) is the most prevalent valvular heart disease (VHD) and represents an important cause of heart failure. Medical therapy has a limited role in improving symptoms and does not hinder the progression of valvular disease. Surgery is the treatment of choice for severe symptomatic MR; valve repair is currently the preferred surgical approach because it reduces peri-operative mortality and ensures a good medium- to long-term survival outcome. Nevertheless, a non-negligible proportion of patients with indications for surgical correction are considered to be at prohibitive perioperative risk, mainly because of old age and multiple comorbidities...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29762929/trileaflet-mitral-valve-treated-with-the-mitraclip%C3%A2-system
#5
Miguel Rodríguez-Santamarta, Rodrigo Estévez-Loureiro, Tomás Benito-González, Javier Gualis, Carmen Garrote, Armando Pérez de Prado, Felipe Fernández-Vázquez
A 79-year-old woman with a history of ischemic dilated cardiomyopathy, severely depressed left ventricular ejection fraction and significant mitral regurgitation (MR) was admitted to the authors´ institution for percutaneous mitral valve repair. Transesophageal echocardiography (TEE) revealed the presence of a posterior mitral cleft at the P2 level, causing a trileaflet mitral valve that contributed significantly to the regurgitant jet. The procedure was performed under general anesthesia and guided by real-time three-dimensional TEE...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29759295/effect-of-acute-kidney-injury-after-percutaneous-mitral-valve-repair-on-outcome
#6
Maximilian Spieker, Katharina Hellhammer, Stratis Katsianos, Julian Wiora, Tobias Zeus, Patrick Horn, Malte Kelm, Ralf Westenfeld
Limited data exist on the occurrence of acute kidney injury (AKI) associated with percutaneous mitral valve repair (PMVR). The objectives of the present study were (1) to assess the prevalence of AKI after MitraClip (Abbott Vascular, Santa Clara, California) implantation, (2) to analyze the predictive factors of AKI, and (3) to evaluate the prognostic value of AKI after PMVR with a view to optimizing the management of high-risk patients. A total of 206 patients (serum creatinine [SCr] 1.3 ± 0.6 mg/dl, estimated glomerular filtration rate 55 ± 24 ml/min) who underwent PMVR were included...
April 17, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29743996/emerging-transcatheter-options-for-tricuspid-regurgitation
#7
REVIEW
Ankur Kalra, Angad S Uberoi, Azeem Latib, Sahil Khera, Stephen H Little, Deepak L Bhatt, Michael J Reardon, Neal S Kleiman, Colin M Barker
Tricuspid regurgitation (TR) presents as either primary valve pathology or secondary to pulmonary or left-sided heart disease. Severe TR portends a worse prognosis independent of age, right ventricular size and function, severe left ventricular dysfunction, and increased pulmonary arterial pressures. Surgical treatment for TR has mostly been limited to patients undergoing mitral valve repair since those at high surgical risk are not candidates for traditional TR surgery. For these patients, minimally invasive techniques could be of great benefit, yet these techniques have been slow to develop because of the various anatomic and physiological aspects of the tricuspid valve apparatus...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743995/percutaneous-repair-of-mitral-regurgitation
#8
REVIEW
Colin M Barker
Mitral regurgitation (MR) affects more than 2 million people in the United States annually and is the second leading cause of heart valve disease after aortic stenosis. Surgical intervention is the currently accepted treatment of choice in patients with either symptomatic degenerative MR or asymptomatic MR with pulmonary hypertension, atrial fibrillation, or left ventricular dysfunction. Based on robust evidence from clinical trials, the MitraClip Transcatheter Mitral Valve Repair system (Abbott Vascular) was approved in the United States for commercial use in 2013...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29742737/inadvertent-defibrillator-lead-placement-into-the-left-ventricle-after-mitraclip-implantation-a-case-report
#9
Giuseppe Santarpia, Francesco Passafaro, Eugenia Pasceri, Annalisa Mongiardo, Antonio Curcio, Ciro Indolfi
RATIONALE: Inadvertent pacemaker/defibrillator lead placement into the left ventricle is an unusual cardiac device-related complication and its diagnosis is not always easy and often misunderstood. Thromboembolic events are frequently associated with this procedural complication. Percutaneous lead extraction should be performed when diagnosis is made early after device implantation while long-life oral anticoagulation is a wise option when the diagnosis is delayed and the lead is not removed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29676043/mitral-valve-interventions-in-heart-failure
#10
REVIEW
Daniel Lavall, Andreas Hagendorff, Stephan H Schirmer, Michael Böhm, Michael A Borger, Ulrich Laufs
Secondary mitral regurgitation (MR) results from left ventricular dilatation and dysfunction. Quantification of secondary MR is challenging because of the underlying myocardial disease. Clinical and echocardiographic evaluation requires a multi-parametric approach. Severe secondary MR occurs in up to one-fourth of patients with heart failure with reduced ejection fraction, which is associated with a mortality rate of 40% to 50% in 3 years. Percutaneous edge-to-edge mitral valve repair (MitraClip) has emerged as an alternative to surgical valve repair to improve symptoms, functional capacity, heart failure hospitalizations, and cardiac haemodynamics...
April 19, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29663512/specific-biomarkers-of-myocardial-inflammation-and-remodeling-processes-as-predictors-of-mortality-in-high-risk-patients-undergoing-percutaneous-mitral-valve-repair-mitraclip
#11
Oliver Dörr, Claudia Walther, Christoph Liebetrau, Till Keller, Hannes Tabert, Niklas Boeder, Matthias Bayer, Pascal Bauer, Helge Möllmann, Luise Gaede, Christian Troidl, Sandra Voss, Timm Bauer, Christian W Hamm, Holger Nef
BACKGROUND: Specific matrix metalloproteinases (MMP-2, MMP-9) and inflammatory biomarkers (hsCRP, IL-6) were found to be consistently up-regulated in severe mitral valve regurgitation (MR) and are associated with mortality in heart failure patients. The aim of the present study was to examine the prognostic value of biomarkers of cardiac inflammation and remodeling processes in predicting mortality in patients with MR undergoing percutaneous mitral valve repair (PMVR). HYPOTHESIS: We hypothesize that increased cardiac inflammation and extracellular matrix turnover is predictive for mortality in patients with severe mitral regurgitation undergoing MitraClip...
April 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29650238/incidence-timing-causes-and-predictors-of-early-and-late-re-hospitalization-in-patients-who-underwent-percutaneous-mitral-valve-repair-with-the-mitraclip-system
#12
Carmelo Grasso, Antonio Popolo Rubbio, Davide Capodanno, Sergio Buccheri, Maria Elena Di Salvo, Stefano Cannata, Salvatore Scandura, Sarah Mangiafico, Silvia Farruggio, Tatiana Salerno, Jessica De Santis, Simona Sanalitro, Anna Caggegi, Giuseppe Castania, Marco Barbanti, Piera Capranzano, Corrado Tamburino
The pattern and reasons for re-hospitalization (RH) after MitraClip implantation are not well characterized. A total of 322 consecutive MitraClip patients were included, with data stratified by RH status. Multivariate analyses were conducted to identify predictors of early (30-day) and late (30-day to 12-month) RH. Eighty-nine patients (27.6%) were readmitted to hospital during the study period and early RH occurred in 27%. The median time from MitraClip to RH was 99 days. RH was mostly related to cardiovascular causes (66...
May 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29627105/utilization-in-hospital-mortality-and-30-day-readmission-after-percutaneous-mitral-valve-repair-in-the-united-states-shortly-after-device-approval
#13
Kamil F Faridi, Jeffrey J Popma, Jordan B Strom, Changyu Shen, Eunhee Choi, Robert W Yeh
The MitraClip device for percutaneous mitral valve repair was approved by the Food and Drug Administration in the United States in October 2013. Few studies have evaluated national outcomes after this procedure in routine clinical practice. We identified adults aged ≥18 years who received percutaneous mitral valve repair from November 2013 to December 2014 in the Nationwide Readmissions Database, a publicly available administrative claims database. Procedural volumes, number of performing hospitals, individual hospital volumes, in-hospital mortality rate, and 30-day hospital readmission rate were determined...
June 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29545259/distinct-hemodynamic-changes-after-interventional-mitral-valve-edge-to-edge-repair-in-different-phenotypes-of-heart-failure-an-integrated-hemodynamic-analysis
#14
Benedikt Schrage, Daniel Kalbacher, Michael Schwarzl, Nicole Rübsamen, Christoph Waldeyer, Peter Moritz Becher, Eike Tigges, Daniel Burkhoff, Stefan Blankenberg, Edith Lubos, Ulrich Schäfer, Dirk Westermann
BACKGROUND: Percutaneous mitral valve edge-to-edge repair (pMVR) with a MitraClip is beneficial for the clinical symptoms of patients irrespective of the ejection fraction (EF). Nevertheless, the consequences on hemodynamics are poorly understood. Therefore, we used data from noninvasive pressure-volume loops to investigate the left ventricular (LV) remodeling of patients after pMVR dependent on their baseline EF. METHODS AND RESULTS: In 130 patients with successful pMVR, the end-diastolic pressure-volume relationship (EDPVR) and end-systolic pressure-volume relationship were estimated noninvasively from echocardiographic data...
March 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29545033/is-surgical-or-catheter-based-interventions-an-option-after-an-unsuccessful-mitral-clip
#15
Felix Kreidel, Hannes Alessandrini, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
The objective of this study was to assess the results of catheter-based and surgical reinterventions in primary mitral regurgitation after failed MitraClip therapy. We report on 21 consecutive symptomatic patients with primary mitral regurgitation (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 (interquartile range [IQR]: 32-622) days after the index procedure, patients had recurrent or persistent grade 3 mitral regurgitation...
March 12, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29482977/transcatheter-mitral-valve-repair-using-the-edge-to-edge-clip
#16
REVIEW
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...
April 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29310672/3d-vena-contracta-area-after-mitraclip%C3%A2-procedure-precise-quantification-of-residual-mitral-regurgitation-and-identification-of-prognostic-information
#17
Alexander Dietl, Christine Prieschenk, Franziska Eckert, Christoph Birner, Andreas Luchner, Lars S Maier, Stefan Buchner
BACKGROUND: Percutaneous mitral valve repair (PMVR) is increasingly performed in patients with severe mitral regurgitation (MR). Post-procedural MR grading is challenging and an unsettled issue. We hypothesised that the direct planimetry of vena contracta area (VCA) by 3D-transoesophageal echocardiography allows quantifying post-procedural MR and implies further prognostic relevance missed by the usual ordinal scale (grade I-IV). METHODS: Based on a single-centre PMVR registry containing 102 patients, the association of VCA reduction and patients' functional capacity measured as six-minute walk distance (6 MW) was evaluated...
January 9, 2018: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/29304185/high-body-mass-index-is-a-risk-factor-for-difficult-deep-sedation-in-percutaneous-mitral-valve-repair
#18
Katharina Hellhammer, Shazia Afzal, Renate Tigges, Maximilian Spieker, Tienush Rassaf, Tobias Zeus, Ralf Westenfeld, Malte Kelm, Patrick Horn
BACKGROUND: The safety and efficacy of deep sedation (DS) in MitraClip® procedures have been shown previously. However, clinical experience demonstrates that in some patients DS is difficult to achieve. We hypothesize that some patient characteristics can predict difficult DS. METHODS: We prospectively analysed 69 patients undergoing MitraClip® procedures using DS. Application of DS was graded as simple (group 1) or difficult (group 2) depending on a cumulative score based on one point for each of the following criteria: decrease in oxygen saturation, retention of carbon dioxide, disruptive body movements, and the need for catecholamines...
2018: PloS One
https://www.readbyqxmd.com/read/29208340/different-indicators-for-postprocedural-mitral-stenosis-caused-by-single-or-multiple-clip-implantation-after-percutaneous-mitral-valve-repair
#19
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
https://www.readbyqxmd.com/read/29204737/initial-slovenian-experience-with-mitraclip-therapy-careful-selection-of-patients-is-crucial-for-optimal-outcome
#20
Jana Ambrožič, Marta Cvijič, Mojca Bervar, Špela Mušič, Matjaž Bunc
BACKGROUND: MitraClip is a percutaneous mitral repair technology increasingly used for high surgical risk patients with primary or secondary mitral regurgitation. We describe initial Slovenian experience with MitraClip and discuss the importance of identifying the suitable candidates for this procedure. METHODS: We retrospectively analyzed the first 10 patients (mean age 75.6 ± 6.9 years, logistic Euroscore 28.4 ± 10.9%) with severe and moderate to severe mitral regurgitation (8 secondary, 1 primary and 1 mixed etiology) who underwent a MitraClip procedure between January 2015 and February 2017...
March 2018: Wiener Klinische Wochenschrift
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