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Transapical mitral valve

Cheng He, Gregory Scalia, Darren L Walters, Andrew Clarke
We describe a successful transcatheter, transapical mitral valve implant within a failed mitral bioprosthesis (valve-in-valve) in a symptomatic 86-year-old patient with prohibitive surgical risks, using the new Sapien 3 balloon-expandable valve. Post-deployment echocardiographic profile of the valve-in-valve was satisfactory and the patient was discharged from hospital uneventfully. This is the first reported case of the Sapien 3 valve used in the mitral valve-in-valve setting.
June 21, 2016: Heart, Lung & Circulation
Krzysztof Wróbel, Katarzyna Kurnicka, Marcin Zygier, Wojciech Dyk, Ryszard Wojdyga, Dariusz Zieliński, Małgorzata Jarzębska, Zbigniew Juraszyński, Barbara Lichodziejewska, Piotr Pruszczyk, Andrzej Biederman, Giovanni Speziali, Uwe Kasten
BACKGROUND AND AIM: Artificial chordal implantation in order to repair flail or prolapse mitral valve leaflet requires open heart surgery and cardiopulmonary bypass. Transapical off-pump implantation of neochordae is a new surgical technique proposed to treat degenerative mitral valve regurgitation. The procedure is performed using the NeoChord DS1000 system (NeoChord, Inc., Eden Praire, MN), which facilitates both implantation and tension adjustment of the neochordae under transesophageal echocardiographic 2D and 3D guidance...
October 7, 2016: Kardiologia Polska
Ali Sait Kavakli, Nilgun Kavrut Ozturk, Raif Umut Ayoglu, Mustafa Emmiler, Lutfi Ozyurek, Kerem Inanoglu, Sadik Ozmen
OBJECTIVES: Various minimally invasive surgical approaches have been used in mitral valve (MV) surgery. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive, alternative procedure for the treatment of degenerative mitral regurgitation. There are several special considerations for the anesthesiologist during the TOP-MINI procedure. The main purpose of this study was to present the anesthetic management of the TOP-MINI procedure...
June 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Erwan Salaun, Philippe Aldebert, Nicolas Jaussaud, Jean-Charles Spychaj, Laurie Anne Maysou, Frederic Collart, Jean-François Avierinos, Jean-Paul Casalta, Thomas Cuisset, Sandrine Hubert, Marc Lambert, Didier Raoult, Sebastien Renard, Gilbert Habib, Jean-Louis Bonnet
No abstract text is available yet for this article.
October 2016: Circulation. Cardiovascular Interventions
Ali Sait Kavakli, Raif Umut Ayoglu, Nilgun Kavrut Ozturk, Omer Haldun Tekinalp, Zehra Erkal, Kerem Inanoglu, Mustafa Emmiler
Elderly patients with severe hematological malignancies may require cardiac surgery. The combined impact of cardiopulmonary bypass (CPB) and surgical trauma is a potent inflammatory activator and is increased by intraoperative and postoperative complications. To avoid the adverse effects of CPB, minimally invasive off-pump techniques may be used in these patients. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive technique for mitral valve repair, which makes it possible to avoid the risks of CPB in selected patients, such as elderly, cancer or immunosuppressive patients...
September 19, 2016: Journal of Anesthesia
Zhaoming He, Kailiang Zhang, Teng Jing, Yong Wang
A novel transapical coaptation plate (TCP) device was developed and anchored by sutures in the mitral valve to treat functional mitral regurgitation. The objective of this study was to test efficacy of the TCP in an in vitro model. Eight fresh porcine mitral valves were mounted in a left heart simulator to simulate functional mitral regurgitation by means of annular dilatation and asymmetrical or symmetrical papillary muscle (PM) displacement. Six polyurethane TCPs in thickness of 6.4(#1), 4.8(#2), 3.2(#3) mm and hardness of durometer 30 A (H) and 30 OO(S),were fabricated and labeled as H1, H2, H3 and S1, S2, S3, respectively...
September 12, 2016: Annals of Biomedical Engineering
Sathish Chikkabyrappa, Doff B McElhinney, Muhamed Saric
We report a rare case of progressive left ventricular outflow tract (LVOT) obstruction after percutaneous device closure of a mechanical prosthetic mitral valve (MV) paravalvular leak (PVL) in the region of aortomitral curtain in a patient who also had small mechanical aortic valve prosthesis with patient-prosthesis mismatch.
August 30, 2016: Echocardiography
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
Conor F Hynes, Omid Fatemi, Aditya C Sharma, Christian D Nagy, Gregory D Trachiotis
We present a complex case of a transapical redo mitral valve-in-valve replacement. Repeat mitral valve replacement was indicated for severe symptomatic bioprosthetic stenosis. In addition to the patient's numerous comorbidities that included diabetes, hepatic cirrhosis, ischemic cardiomyopathy, and atrial flutter, he had undergone a previous open mitral valve replacement that was complicated by sternal dehiscence requiring extensive chest wall reconstruction. Transapical approach was performed through left minithoracotomy incision with balloon-expandable valve...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Kristina Wachter, Samir Ahad, Christian J Rustenbach, Ulrich F W Franke, Hardy Baumbach
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has proven to be a valid option for patients with severe aortic stenosis who are at high perioperative risk, particularly in patients with previous cardiac surgery. Several patients with previous mitral valve surgery were reported to have been successfully treated with TAVI. CASE PRESENTATION: Two patients, one with mechanical and one with biological mitral valve prosthesis, presented with symptomatic severe aortic stenosis...
2016: Journal of Cardiothoracic Surgery
Edo Bedzra, Creighton W Don, Mark Reisman, Gabriel S Aldea
A 71-year-old man presented with New York Heart Association (NYHA) class IV heart failure. He had undergone transapical mitral valve replacement for mixed mitral stenosis and mitral regurgitation. At the 1 month follow-up, the patient reported symptom resolution. An echocardiogram revealed a low gradient and no regurgitation. Our case shows that with careful multidisciplinary evaluation, preoperative planning, and patient selection, percutaneous mitral intervention can become an alternative therapy for high-risk patients who cannot undergo conventional surgical therapy...
August 2016: Annals of Thoracic Surgery
James S Gammie, Peter Wilson, Krzysztof Bartus, Andrzej Gackowski, Judy Hung, Michael N D'Ambra, Piotr Kolsut, Gregory J Bittle, Piotr Szymanski, Jerzy Sadowski, Boguslaw Kapelak, Agata Bilewska, Mariusz Kusmierczyk, Mehrdad Ghoreishi
BACKGROUND: Degenerative mitral valve (MV) disease is a common cause of severe mitral regurgitation (MR) and accounts for the majority of MV operations. Conventional MV surgery requires cardiopulmonary bypass, aortic cross-clamping, cardioplegia, and a thoracotomy or sternotomy and, therefore, is associated with significant disability, risks, and unpredictable rates of MV repair. Transesophageal echocardiography-guided beating-heart MV repair with expanded polytetrafluoroethylene cordal insertion has the potential to significantly reduce surgical morbidity...
July 19, 2016: Circulation
Javier Gualis, Rodrigo Estévez-Loureiro, David Alonso, Jose Manuel Martínez-Comendador, Elio Martín, Mario Castaño
We report a case of transapical mitral valve-in-valve implantation for a deteriorated bioprosthesis using the Edwards Sapien 3 prosthesis via the transapical approach. This case demonstrates the safety and feasibility of using the Edwards Sapien 3 prosthesis in treating degenerated bioprosthetic mitral valves.
September 2016: Journal of Cardiac Surgery
Mayra Guerrero, Danny Dvir, Dominique Himbert, Marina Urena, Mackram Eleid, Dee Dee Wang, Adam Greenbaum, Vaikom S Mahadevan, David Holzhey, Daniel O'Hair, Nicolas Dumonteil, Josep Rodés-Cabau, Nicolo Piazza, Jose H Palma, Augustin DeLago, Enrico Ferrari, Adam Witkowski, Olaf Wendler, Ran Kornowski, Pedro Martinez-Clark, Daniel Ciaburri, Richard Shemin, Sami Alnasser, David McAllister, Martin Bena, Faraz Kerendi, Gregory Pavlides, Jose J Sobrinho, Guilherme F Attizzani, Isaac George, George Nickenig, Amir-Ali Fassa, Alain Cribier, Vinnie Bapat, Ted Feldman, Charanjit Rihal, Alec Vahanian, John Webb, William O'Neill
OBJECTIVES: This study sought to evaluate the outcomes of the early experience of transcatheter mitral valve replacement (TMVR) with balloon-expandable valves in patients with severe mitral annular calcification (MAC) and reports the first large series from a multicenter global registry. BACKGROUND: The risk of surgical mitral valve replacement in patients with severe MAC is high. There are isolated reports of successful TMVR with balloon-expandable valves in this patient population...
July 11, 2016: JACC. Cardiovascular Interventions
Anton Tomšič, Meindert Palmen, Michel I M Versteegh, Frank van der Kley, Hans-Marc J Siebelink, Remco R Berendsen, Martin J Schalij
Transapical valve-in-valve mitral valve implantation (TA-MVI) has been described as an alternative treatment option in patients with degenerated bioprostheses in the mitral position. We report the first case of prosthesis dislocation and migration into the left atrium after TA-MVI. A new prosthesis was implanted using the same approach. The dislocated prosthesis was successfully removed through the left atrial appendage through an extended anterolateral thoracotomy without the use of cardiopulmonary bypass.
March 19, 2016: Canadian Journal of Cardiology
Vincenzo Pestrichella, Antonio Pignatelli, Rossella Alemanni, Rosamaria Montesanti, Maurizio Braccio, Francesco Greco, Pierpaolo D'Ambruoso, Cataldo Davide Memmola, Mauro Cassese, Gaetano Contegiacomo, Rodrigo Bagur
A 67-year-old patient with rheumatic heart valve disease had undergone two cardiac surgeries at the age of 30 years, then re-do with mitral valve replacement at 50 years. She presented with congestive heart failure and hemolytic anemia. Doppler echocardiography showed moderate-severe mitral regurgitation due to paravalvular mitral valve leak (PVML) and severe pulmonary hypertension. Transesophageal echocardiography demonstrated severe PVML secondary to a large 20 mm-long PVML defect. Due to comorbidities, the heart team deemed a third reoperation at very high surgical risk; therefore, the patient was considered most suitable for a transcatheter approach to PVML closure...
July 2016: Journal of Invasive Cardiology
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
Danny Dvir
No abstract text is available yet for this article.
June 13, 2016: JACC. Cardiovascular Interventions
Grzegorz Smolka, Piotr Pysz, Michał Kozłowski, Marek Jasiński, Radosław Gocoł, Tomasz Roleder, Agnieszka Kargul, Andrzej Ochała, Wojciech Wojakowski
INTRODUCTION: Transcatheter paravalvular leak closure (TPVLC) has become an established treatment option but is mostly performed with off-label use of different non-dedicated occluders. The first one specifically designed for TPVLC is the paravalvular leak device (PLD - Occlutech). AIM: We present initial short-term results of a prospective registry intended to assess the safety and efficacy of TPVLC with PLD. MATERIAL AND METHODS: We screened patients with paravalvular leak (PVL) after surgical valve replacement (SVR)...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Rakesh M Suri, Sa'ar Minha, Oluseun Alli, Ron Waksman, Charanjit S Rihal, Lowell P Satler, Kevin L Greason, Rebecca Torguson, Augusto D Pichard, Michael Mack, Lars G Svensson, Jeevanantham Rajeswaran, Ashley M Lowry, John Ehrlinger, Stephanie L Mick, E Murat Tuzcu, Vinod H Thourani, Raj Makkar, David Holmes, Martin B Leon, Eugene H Blackstone
OBJECTIVES: Introduction of hybrid techniques, such as transapical transcatheter aortic valve replacement (TA-TAVR), requires skills that a heart team must master to achieve technical efficiency: the technical performance learning curve. To date, the learning curve for TA-TAVR remains unknown. We therefore evaluated the rate at which technical performance improved, assessed change in occurrence of adverse events in relation to technical performance, and determined whether adverse events after TA-TAVR were linked to acquiring technical performance efficiency (the learning curve)...
September 2016: Journal of Thoracic and Cardiovascular Surgery
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