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Mitral valve percutaneous intervention

Daisuke Francis Nonaka, Amanda Arlene Fox
The treatment strategy for ischemic mitral regurgitation (MR) continues to evolve with the completion of multicenter trials and the advancement of surgical and percutaneous interventional techniques. This review defines ischemic MR, outlines key clinical trials that assess surgical and interventional approaches, and reports the main elements of recent national guidelines for decision making in treatment of ischemic MR. New findings in percutaneous mitral valve repair and replacement for ischemic MR will also be described...
August 13, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Christine Attenhofer Jost, Philippe Müller, Osmund Bertel, Barbara Naegeli, Christoph Scharf, Peter Wenaweser, Franz Wolfgang Amann
The Old-Age Heart Abstract. Knowledge of cardiovascular changes in old age and their therapeutic options is important. Old age can lead to hypertrophy of the left ventricle, diastolic dysfunction, heart valve changes and pulmonary hypertension. Patients often develop arterial hypertension. Valvular changes are common in people over 100 years of age (aortic stenosis and mitral insufficiency). The risk of coronary heart disease is 35 % for men and 24 % for women. In old age, sinus node dysfunction and atrial fibrillation are common...
August 2018: Praxis
Konrad Stępień, Karolina Połetek, Michał Komornik, Zbigniew Siudak, Tomasz Tokarek, Dariusz Dudek
INTRODUCTION: Interventional cardiology (IC) is a rapidly expanding field of medicine. Medical studies should provide students the necessary level of knowledge about new techniques in IC. The aim of the study was to assess the medical students' knowledge about various new areas of IC. MATERIAL AND METHODS: Self-designed questionnaire was used to assess student's knowledge. It contained 31 questions. The initial 3 questions concerned general information, the remaining ones were related to different IC techniques: Transcatheter Aortic Valve Implantation (TAVI), Bioresorbable Vascular Scaffold (BVS), percutaneous mitral regurgitation repair methods, Left Atrial Appendage Occlusion (LAAO), Renal DeNervation (RDN), Balloon Aortic Valvuloplasty (BAV) and Atrial Septal Defect/Persistent Foramen Ovale (ASD/PFO)...
2018: Folia Medica Cracoviensia
Nicolas A Geis, Sven T Pleger, Raffi Bekeredjian, Emmanuel Chorianopoulos, Michael M Kreusser, Lutz Frankenstein, Arjang Ruhparwar, Hugo A Katus, Philip W J Raake
AIMS: Functional mitral regurgitation is complicating end-stage heart failure and potential heart transplantation by increasing pulmonary artery pressures. The aim of the present study was to investigate feasibility and haemodynamic effects of percutaneous mitral valve edge-to-edge repair using the MitraClip™ device in patients with end-stage heart failure awaiting heart transplantation. METHODS AND RESULTS: In this retrospective study, we identified nine patients suffering from end-stage heart failure listed for heart transplantation in whom moderate-severe or severe functional mitral regurgitation was recognized and treated with percutaneous mitral valve edge-to-edge repair...
July 30, 2018: ESC Heart Failure
Joanna B Hrabia, Elahn P L Pogue, Alexander G Zayachkowski, Dorota Długosz, Olga Kruszelnicka, Andrzej Surdacki, Bernadeta Chyrchel
In the assessment of cardiovascular disease, the clinical significance of left atrial (LA) pressure-volume relations has largely been overlooked in contrast to left ventricular (LV) compliance. However, LA compliance has recently gained more attention. Net atrioventricular compliance ( Cn ), a joint measure of LA and LV compliance, can be calculated non-invasively by a previously validated method using parameters from standard echocardiography. Compliance measurement may be of relevance in selected clinical settings...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Tiffany Chen, Victor A Ferrari, Frank E Silvestry
Chronic mitral regurgitation (MR), whether due to valve degeneration or secondary to myocardial disease, affects an increasing proportion of the aging population. Percutaneous mitral valve interventions, including edge-to-edge repair, are emerging as feasible and effective therapy for patients with severe MR at high or prohibitive surgical risk. Imaging with echocardiography is crucial for patient selection by evaluating mitral anatomy, the mechanism of dysfunction, and MR severity. In this article, the authors review the imaging characteristics for identifying and quantifying degenerative and functional MR for transcatheter mitral valve repair...
July 2018: Interventional cardiology clinics
Damiano Regazzoli, Antonio Mangieri, Ozan Demir, Marco B Ancona, Giuseppe Lanzillo, Francesco Giannini, Pier P Leone, Antonio Colombo, Azeem Latib
Tricuspid valve regurgitation has a high prevalence and, when severe, is associated with poor outcomes. Nevertheless, surgical repair or replacement (isolated or as a part of a combined procedure) is rarely performed due to high surgical risk. Therefore, there is a significant unmet clinical need for percutaneous transcatheter-based treatments. Significant development in percutaneous therapies for both aortic and mitral valve disease has been accomplished over the last two decades, while transcatheter therapies for the tricuspid valve are still at an early stage...
June 29, 2018: Minerva Cardioangiologica
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
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
Nina C Wunderlich, Roy Beigel, Siew Y Ho, Fabian Nietlispach, Richard Cheng, Eustachio Agricola, Robert J Siegel
The mitral valve (MV) is a complex and intricate structure. With the development of transesophageal echocardiography in the 1990s, it became possible to evaluate MV anatomy and function in real time during surgical procedures. Subsequently, new surgical and percutaneous techniques for MV repair as well as replacement have evolved. Development of 3-dimensional and intracardiac echocardiography, as well as computed tomography, cardiac resonance imaging, and most recently fusion imaging, have paved the way for a more comprehensive evaluation of the MV as well as for the planning of percutaneous MV procedures such as balloon valvuloplasty, paravalvular mitral leak closure, percutaneous edge-to-edge repair, transcatheter MV annuloplasty, artificial chord implantation, and transcatheter MV replacement...
June 2018: JACC. Cardiovascular Imaging
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
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Matteo Saccocci, Maurizio Taramasso, Francesco Maisano
PURPOSE OF REVIEW: Analyze the current state of the art and the future perspectives of mitral interventions in clinical setting. RECENT FINDINGS: A systematic and critical review of the new mitral percutaneous therapies and imaging technologies is the basis to adopt the right treatment for each patient according to specific valve dysfunction and clinical presentation, waiting for definitive guidelines. While surgical mitral repair will remain the gold standard for low-risk healthy patients with degenerative mitral regurgitation (DMR), transcatheter mitral valve repair is becoming first line therapy in high risk patients with functional mitral regurgitation (FMR)...
May 17, 2018: Current Cardiology Reports
K Selthofer-Relatic
Background: Anderson-Fabry disease is an X-linked inherited disease, which manifests in a different manner depending on gender and genotype. Making a working diagnosis of Anderson-Fabry disease is difficult because of several reasons: (a) that it is a multiorgan disease with wide variety of phenotypes, (b) different timelines of presentation, (c) gender differences, and (d) possible coexistence with other comorbidities. Late-onset/cardiac type of presentation with minimal involvement of other organs can additionally make diagnosis difficult...
2018: Case Reports in Cardiology
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
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)
Shinji Kanemitsu, Shunsuke Sakamoto, Naoki Yamamoto, Hideto Shimpo
Papillary muscle rupture is a rare complication after myocardial infarction. Almost all cases occur in the papillary muscle of the mitral valve. The development of tricuspid regurgitation after right ventricular myocardial infarction caused by papillary muscle rupture is extremely rare. We present a 70-year-old man with massive tricuspid regurgitation caused by papillary muscle rupture after percutaneous coronary intervention to the right coronary artery involving a stent. We performed tricuspid valve repair with a reimplanted papillary muscle in situ using neither artificial chordae nor a prosthetic valve...
May 3, 2018: European Journal of Cardio-thoracic Surgery
Marko Banovic, Mark DaCosta
Mitral stenosis (MS) is characterized by obstruction of left ventricular inflow as a result of narrowing of the mitral valve orifice. Although its prevalence has declined over the last decade, especially in developed countries, it remains an important cause of morbidity and mortality.  The most often cause of MS worldwide is still postrheumatic mitral valve disease. However, in developed countries, degenerative or calcific changes cause MS in a siginificant proportion of patients. Although the range of treatment for mitral valve disease has grown over the years in parallel with transcatheter therapies for aortic valve disease, these improvements in mitral valve disease therapy have experienced slower development...
April 6, 2018: Current Problems in Cardiology
Judith E Lowry, Stephan Fichtlscherer, Klaus K Witte
Mitral regurgitation is a common finding in patients with chronic heart failure and is associated with a progressive worsening of symptoms, reduced survival and increased cost of care. However, the use of mitral valve surgery for these patients remains controversial and has not been shown to improve survival. Consequently, research has been increasingly directed towards the nonsurgical management of this important co-morbidity of heart failure. Areas covered: The present review will describe the relevance of mitral regurgitation in people with chronic heart failure, the current options for percutaneous treatment and the evidence base for each of these...
May 2018: Expert Review of Medical Devices
Shyam Kumar Singh Thingnam, Sachin Mahajan, Vikas Kumar
Background Percutaneous device closure of an ostium secundum atrial septal defect is associated with excellent outcomes and cosmetic results but at the cost of occasional serious and sometimes fatal complications as well as lifelong follow-up. Surgical intervention is required in cases of device-related complications, which carries a slightly higher risk compared to primary closure of an atrial septal defect. We present a surgical perspective of device closure of atrial septal defect. Methods Our database was searched over 4 years for complications related to percutaneous device closure of atrial septal defect, which required surgical retrieval of the device and closure of the defect...
June 2018: Asian Cardiovascular & Thoracic Annals
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