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Marina Urena, Eric Brochet, Milena Lecomte, Caroline Kerneis, Jose Luis Carrasco, Walid Ghodbane, Jérémie Abtan, Soleiman Alkhoder, Richard Raffoul, Bernard Iung, Patrick Nataf, Alec Vahanian, Dominique Himbert
Aims: We analysed the early and long-term clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation (TMVI) in an experienced centre. Methods and results: All patients undergoing TMVI from July 2010 to July 2017 in our centre were prospectively included. Indication for TMVI relied on the judgement of the local heart team. Patients were followed at 1 month, 1 year, and yearly thereafter. A total of 91 patients underwent TMVI...
May 19, 2018: European Heart Journal
Daisuke Hachinohe, Azeem Latib, Matteo Montorfano, Antonio Colombo
Transcatheter mitral valve implantation (TMVI) has been performed in high-risk and inoperable patients for degenerated mitral bioprostheses (TMVIinV) and failed annuloplasty rings (TMVIinR). TMVIinR is more challenging compared to TMVIinV because of the differences in dimensions, shapes, and contours between rings and valves. In this report, we present two clinical cases of TMVIinR that were treated by trans-septal implantation of a balloon-expandable prosthesis. In TMVI cases with an incomplete ring, the ring will be stretched out toward its anterior and commissural side, and the open side of the ring will increase in width...
May 18, 2018: Catheterization and Cardiovascular Interventions
Ryan Markham, Stephen Kyranis, Nicholas Aroney, Katherine Lau, Karl Poon, Gregory Scalia, Darren Walters
Mitral regurgitation (MR) is a valvular heart disease associated with significant morbidity and mortality. Transcatheter mitral valve intervention (TMVI) repairs or replaces the mitral valve through small arterial and venous entry sites and so avoids risks associated with open heart surgery. Transcatheter devices targeting components of the mitral apparatus are being developed to repair or replace it. Numerous challenges remain including developing more adaptable devices and correction of multiple components of the mitral annulus to attain durable results...
April 2018: Internal Medicine Journal
Elise Paven, Claire Cimadevilla, Marina Urena, Marie-Pierre Dilly, Patrick Nataf, Richard Raffoul, Dominique Himbert, Alec Vahanian, David Messika-Zeitoun
No abstract text is available yet for this article.
February 2, 2018: EuroIntervention
M A Karaskov, Y I Zhuravleva, V A Bogachev-Prokophiev, P D Demidov
Mitral valve disease is highly prevalent and quickly leads to development of severe heart failure. Mitral valve disease of degenerative or ischemic etiology affects 7.5 and 9.3% of population older than 65 and 75 years, respectively. "Open" (with cardiopulmonary bypass) surgical repair or valve replacement are not possible in almost half of affected patients because of their complications and concomitant diseases responsible for extremely high risk of these interventions. In the last decade, minimally invasive endovascular technology - transcatheter aortic valve implantation (TAVI) - has been widely introduced for correction of aortic valve disease in similar category of patients...
August 2017: Kardiologiia
Gina Granja-Galeano, Carlos Daniel Zappia, Lucas Fabián, Carlos Davio, Carina Shayo, Natalia Fernández, Federico Monczor
Despite the pivotal role GPCRs play in cellular signaling, it is only in the recent years that structural biology has begun to elucidate how GPCRs function and to provide a platform for structure-based drug design. It is postulated that GPCR activation involves the movement of transmembrane helices. The finding that many residues, which have been shown to be critical for receptor activation and are highly conserved among different GPCRs, are clustered in particular positions of transmembrane helices suggests that activation of GPCRs may involve common molecular mechanisms...
December 15, 2017: Biochemical Pharmacology
Philipp Kiefer, Thilo Noack, Joerg Seeburger, Alexandro Hoyer, Axel Linke, Norman Mangner, Lukas Lehmkuhl, Friedrich Wilhelm Mohr, David Holzhey
BACKGROUND: Transcatheter mitral valve implantation (TMVI) is still in its infancy and is mainly limited to valve-in-valve or valve-in-ring implantations. We present the early experience with TMVI for severe calcified native MV stenosis. METHODS: Between January 2014 and June 2015, 6 of 11 patients screened (mean age, 77.4 ± 6.3 years; 66% men) with severe native mitral valve (MV) stenosis (mean gradient [Pmean], 11.1 ± 2.1 mm Hg; mean effective orifice area [EOA], 0...
December 2017: Annals of Thoracic Surgery
Dimitris Klettas, Emma Alcock, Rafal Dworakowski, Philip MacCarthy, Mark Monaghan
AIM: The role of transoesophageal echocardiography in cardiac interventional structural procedures is well established and appreciated. However, the need for general anaesthesia (GA) throughout the procedure remains a controversial issue. The aim of the present study is to assess the feasibility and imaging quality of using a transnasal microrobe that allows the usage of conscious sedation in patients who undergo cardiac structural interventional procedures without missing the benefits, guidance and navigation of conventional trans-procedural TEE...
March 2017: Echo Research and Practice
Cesare Quarto, Simon Davies, Alison Duncan, Alistair Lindsay, Georg Lutter, Lucian Lozonschi, Neil Moat
OBJECTIVE: A small number of transcatheter mitral valve implants (TMVIs) have been reported using devices designed to treat secondary mitral regurgitation (MR). However, MR has many etiologies, and patients have a broad spectrum of annular size, geometry, and lesions. There are a number of technical challenges for TMVI including left ventricular outflow tract obstruction and paravalvular MR. Thirty days' outcome of first-in-man implants with a novel TMVI device is reported. METHODS: The Tendyne TMVI system consists of a porcine pericardial valve in a tethered nitinol frame...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Danny Dvir, Anson Cheung, Robert Boone, Jonathon Leipsic, Philipp Blanke, Gidon Perlman, Robert Moss, Mustafa Toma, Dion Stub, Shmuel Banai, John Webb
AIMS: Transcatheter mitral valve implantation (TMVI) is a novel approach that may enable a less invasive effective reduction of mitral regurgitation (MR). A limitation of the MitraClip is that definitive implantation of a clip precludes future therapy with TMVI. The purpose of this paper is to describe contemporary treatment considerations in patients with mitral valve regurgitation. METHODS AND RESULTS: In this report we describe an attempted MitraClip implantation which resulted in no reduction of MR severity...
June 12, 2016: EuroIntervention
Samir R Kapadia, Amgad Mentias, Amr F Barakat, Mohammad Q Raza, Kanhaiya Lal Poddar, Cristian Baeza, Gabriel Maluenda, Jose Navia, Paul Schoenhagen, E Murat Tuzcu
AIM: Transcatheter mitral valve implantation (TMVI) is a novel technology for patients with severe mitral valve disease but at high surgical risk. Imaging guidance during the procedure is critical for successful device deployment. Identification of the mitral annular plane (MAP) with fluoroscopy during the procedure is limited by lack of clearly defined landmarks. We hypothesized that a plane defined by left circumflex-right coronary arteries (LCX-RCA) would have a consistent relationship to MAP...
April 2017: Catheterization and Cardiovascular Interventions
Bo Xu, Robert Gooley, Sujith K Seneviratne, Arthur Nasis
In recent years, there have been major advances in structural interventional cardiology, which have revolutionized the practice of cardiology. Appropriate selection and follow-up of patients undergoing these structural heart interventions is vital. Multi-detector computed tomography (MDCT) has emerged as a key imaging modality in the peri-procedural assessment of patients undergoing multiple structural cardiac interventions. The purpose of this review is to provide an evidence-based clinical update on the roles of MDCT in both established and evolving structural heart interventions, including transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve implantation (TMVI)...
June 2016: Journal of Medical Imaging and Radiation Oncology
Rishi Puri, Omar Abdul-Jawad Altisent, Maria del Trigo, Francesco Campelo-Parada, Ander Regueiro, Henrique Barbosa Ribeiro, Robert DeLarochellière, Jean-Michel Paradis, Eric Dumont, Josep Rodés-Cabau
BACKGROUND: Transcatheter mitral valve implantation (TMVI) for severely calcified native mitral valve disease recently emerged as a treatment option in patients deemed inoperable by conventional techniques. Yet no systematic appraisal currently exists characterizing this novel treatment paradigm. METHODS: A systematic literature review summarizing the clinical, anatomical, peri- and post-procedural characteristics underscoring the technical feasibility of this procedure was performed...
February 15, 2016: Catheterization and Cardiovascular Interventions
Francesco Romeo, Valeria Cammalleri, Giovanni Ruvolo, Arshad Quadri, Pasquale De Vico, Saverio Muscoli, Massimo Marchei, Sabrina Meloni, Fabio Conti, Gian Paolo Ussia
Trans-catheter mitral valve implantation (TMVI) is actually the most attractive technique for treating patients with severe mitral regurgitation, who are denied surgical therapy. Recently, trans-catheter implantation of aortic biological prosthesis in mitral position has been done in compassionate cases, and very few experiences of TMVI in native non-calcified valves have been recently reported in very-high-risk patients, mainly with functional mitral regurgitation.Here, we report our case of TMVI using the second-generation CardiAQ prostheisis (CardiAQ Valve Technologies, Irvine, California, USA), reviewing the current state of the art...
February 2016: Journal of Cardiovascular Medicine
Philipp Blanke, Christopher Naoum, John Webb, Danny Dvir, Rebecca T Hahn, Paul Grayburn, Robert R Moss, Mark Reisman, Nicolo Piazza, Jonathon Leipsic
Transcatheter mitral valve implantation (TMVI) represents a promising approach to treating mitral valve regurgitation in patients at increased risk of perioperative mortality. Similar to transcatheter aortic valve replacement (TAVR), TMVI relies on pre- and periprocedural noninvasive imaging. Although these imaging modalities, namely echocardiography, computed tomography, and fluoroscopy, are well established in TAVR, TMVI has entirely different requirements. Approaches and nomenclature need to be standardized given the multiple disciplines involved...
October 2015: JACC. Cardiovascular Imaging
M Saxena, S S Bhunia, A K Saxena
The human histamine H2 receptor (hH2HR) is a G-protein coupled receptor protein with seven transmembrane (TM)-spanning helices primarily involved in regulation of gastric acid secretion. Antagonists targeting hH2HR are useful in the treatment of hyperacidic conditions such as peptic ulcers, gastresophageal reflux disease and gastrointestinal bleeding. We have previously reported the antagonism of 2-substituted pyrazinopyridoindoles at the human histamine H1 receptor and mode of binding of these compounds at the hH1HR using in silico methods...
2015: SAR and QSAR in Environmental Research
Darren Mylotte, Nicolo Piazza
In the last year transcatheter mitral valve implantation (TMVI) has seen a major jump in development. This technique offers the potential to treat a great number of elderly and/or high-risk patients with severe mitral regurgitation (MR). Such patients are declined surgical intervention either because the institutional Heart Team considers the risk of intervention to exceed the potential benefit, or because the patients and their families believe the morbidity of mitral surgery to be excessive. The advent of a less invasive transcatheter treatment could, therefore, potentially appeal to both clinicians and patients alike...
September 2015: EuroIntervention
Maurizio Taramasso, Francesco Maisano
Over the last few years, several surgical procedures to treat mitral regurgitation (MR) in high-risk or inoperable patients have inspired percutaneous devices, including valve repair and valve replacement technologies. As the field of transcatheter mitral valve intervention is rapidly developing, the interventional community is wondering whether valve implantation should become the leading percutaneous mitral valve therapy, and whether the introduction of reliable replacement technology will reduce the clinical value of repair approaches...
September 2015: EuroIntervention
Philipp Blanke, Danny Dvir, Christopher Naoum, Anson Cheung, Jian Ye, Pascal Thériault-Lauzier, Marco Spaziano, Robert H Boone, David A Wood, Nicolo Piazza, John G Webb, Jonathon Leipsic
BACKGROUND: We sought to determine if preprocedural CT can predict appropriate fluoroscopic angulations to achieve a coplanar view during transcatheter mitral valve implantation (TMVI) and to assess the relationship of the mitral annulus and the coronary sinus to determine the feasibility of using this as an additional landmark on fluoroscopy. METHODS: With CT, the mitral annulus was segmented in 25 patients with functional mitral regurgitation. After this, optimal projection curves were plotted and the necessary angulations for specific views parallel to the trigone-to-trigone line (TT view) and septal-to-lateral distance (SL view) were noted...
May 2015: Journal of Cardiovascular Computed Tomography
Lars Sondergaard, Matthew Brooks, Nikolaj Ihlemann, Anders Jonsson, Susanne Holme, Mariann Tang, Kim Terp, Arshad Quadri
OBJECTIVES: As many as 50% of patients with severe symptomatic mitral valve regurgitation are denied surgical valve replacement or repair due to high operative risk. We describe an early series of cases of transcatheter implantation with a CardiAQ™ mitral valve via a transapical approach. METHODS: Three consecutive patients with an Society of Thoracic Surgeons (STS) mortality score of >22% were selected for transcatheter mitral valve implantation (TMVI) on compassionate grounds...
December 2015: European Journal of Cardio-thoracic Surgery
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