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Mitral valve percutaneous intervention

Jamshid H Karimov, Tomislav Mihaljevic, Shengqiang Gao, Gengo Sunagawa, Patrick Grady, Martin Sinkewich, Kiyotaka Fukamachi
OBJECTIVE: With heart disease increasing worldwide, demand for new minimally invasive techniques and transcatheter technologies to treat structural heart disease is rising. Cardioscopy has long been considered desirable, as it allows direct tissue visualization and intervention to deliver therapy via a closed chest, with real-time fiber-optic imaging of intracardiac structures. Herein, the feasibility of the advanced cardioscopic platform, allowing both transapical and fully percutaneous access is reported...
October 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
Ana Belén Cid Álvarez, Oriol Rodríguez Leor, Raúl Moreno, Armando Pérez de Prado
INTRODUCTION AND OBJECTIVES: To present the annual report of the Working Group on Cardiac Catheterization and Interventional Cardiology on the activity data for 2017. METHODS: Data were voluntarily provided by Spanish centers with a catheterization laboratory. The information was introduced online and was analyzed by the Steering Committee of the Working Group on Cardiac Catheterization and Interventional Cardiology. RESULTS: In 2017, data were reported by 107 hospitals, of which 82 are public...
October 5, 2018: Revista Española de Cardiología
Deepak Thakur, Yerramareddy Vijaya Chandra, Chinnasamy Sivaprakasam Muthukumaran
Rheumatic heart disease (RHD) is a major health hazard in most developing countries as well as sporadically in developed economies with high prevalence rates. Mitral stenosis is among the important morbid valvular conditions accounting for 25% of RHD cases. Percutaneous transmitral commissurotomy (PTMC) using Inoue balloon is the standard treatment for severe mitral stenosis with favorable Wilkins score. In certain cases it is difficult to cross mitral valve (MV) either due to dilated left atrium (LA), low septal puncture, or severe mitral valvular and subvalvular stenosis leading to prolonged procedure time or failure of PTMC procedure...
April 2018: Journal of Cardiology Cases
Andreas Glatthaar, Peter Seizer, Johannes Patzelt, Harald Langer, Jürgen Schreieck, Meinrad Gawaz
Percutaneous mitral valve repair (PMVR) using the MitraClip system (Abbott, Abbott Park, IL, USA) is an innovative method allowing treatment of mitral regurgitation (MR) for patients that are not accessible by conventional operation. Thrombogenicity in the left atrium (LA) in general is increased in the presence of atrial fibrillation and mitral valve disease. We observed in a patient who underwent PMVR an acute change in thrombogenicity in the LA with thrombus formation in the left atrial appendix (LAA) immediately after clip placement...
January 2018: Journal of Cardiology Cases
Fahad Alqahtani, Khaled Ziada, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Coronary ischemia requiring early percutaneous coronary intervention (PCI) is a rare but serious complication of isolated valve surgery. We sought of assess the incidence, predictors and outcomes of early PCI after isolated valve surgery using the national inpatient sample. METHODS: Patients who underwent isolated aortic valve replacement (AVR), isolated mitral valve repair (MVr) or replacement (MVR) between 2003 and 2014 were identified. Patients who had early postoperative PCI were compared with patients who did not require PCI...
September 30, 2018: Catheterization and Cardiovascular Interventions
Mirjam Keßler, Julia Seeger, Jochen Wöhrle, Wolfgang Rottbauer, Sinisa Markovic
OBJECTIVES: To analyze 30-day and 6-month results after percutaneous mitral valve repair using an IABP as circulatory support. BACKGROUND: The use of intra-aortic balloon counterpulsation pump extended the spectrum of cardiovascular interventions. METHODS: Since 2014, 17 patients of 365 patients (4.7%) at our center received an IABP during MitraClip implantation procedure. We compare the periprocedural results to a control group of 17 patients treated with MitraClip without an IABP support...
September 30, 2018: Catheterization and Cardiovascular Interventions
Farshad Tahmasebi, Alice Hurrell, Amie Ford, Manish Gupta, Damien Geindreau, Dominic Pimenta, Constantinos O'Mahony
Spontaneous coronary artery dissection is a rare but important cause of acute coronary syndrome. Its relevance for women during the puerperium mandates awareness and understanding amongst obstetric healthcare professionals. The aetiology of the increased risk in pregnancy has not been fully elucidated, but include medial eosinophilic angitis, pregnancy-induced degeneration of collagen in conjunction with the stresses of parturition, and rupture of the vasa vasorum. The risk of mortality necessitates prompt diagnosis, usually by angiography...
September 2018: Obstetric Medicine
Konstantinos Koutsampasopoulos, Savvas Grigoriadis, Ioannis Vogiatzis
Introduction We herein present an unusual case of a pseudoaneurysm of the left ventricular myocardium, which is a rare and fatal complication of myocardial infarction. Case report A 64-year-old man with a history of bipolar disorder and arterial hypertension was hospitalized for delayed presentation ST-elevation myocardial infarction. He was admitted to our hospital 24 hours after symptom onset. Diagnostic coronary angiography revealed 95% stenosis at the distal third of the right coronary artery, and he underwent a primary percutaneous coronary intervention to the culprit lesion...
September 5, 2018: Journal of International Medical Research
Lorenzo Faggioni, Michela Gabelloni, Sandra Accogli, Marco Angelillis, Giulia Costa, Paolo Spontoni, Anna Sonia Petronio, Davide Caramella
Mitral regurgitation is the most common valve disorder in the Western world, and although surgery is the established therapeutic gold standard, percutaneous transcatheter mitral interventions are gaining acceptance in selected patients who are inoperable or at an exceedingly high surgical risk. For such patients, multidetector computed tomography (MDCT) can provide a wealth of valuable morphological and functional information in the preoperative setting. Our aim is to give an overview of the MDCT image acquisition protocols, post-processing techniques, and imaging findings with which radiologists should be familiar to convey all relevant information to the Heart Team for successful treatment planning...
2018: European Journal of Radiology Open
Deepakraj Gajanana, Toby Rogers, William S Weintraub, Micaela Iantorno, Kyle D Buchanan, Itsik Ben-Dor, Augusto D Pichard, Lowell F Satler, Vinod H Thourani, Rebecca Torguson, Petros G Okubagzi, Ron Waksman
There is scarcity of evidence regarding antiplatelet and anticoagulant therapy in patients with prosthetic valves undergoing percutaneous coronary intervention (PCI). Our goal was to compare clinical outcomes between patients with mechanical or bioprosthetic valves undergoing PCI. The study population comprised patients with either a bioprosthetic or mechanical heart valve in the aortic and/or mitral position undergoing PCI between January 2003 and July 2017. Demographics, admission, and discharge medications as well as procedural details were documented...
August 3, 2018: American Journal of Cardiology
Robinder S Sidhu, Benjamin D Tyrrell, Robert C Welsh, Steven R Meyer, Miriam Shanks, Kevin R Bainey
Chronic mitral regurgitation (MR) remains a common cardiovascular condition resulting in significant morbidity and mortality. With an aging population, increasing trends for both primary (degenerative) and secondary (functional) MR have become apparent. Although the gold standard remains surgical intervention with mitral valve repair/replacement, comorbid conditions have steered the development of less invasive technologies to mitigate perioperative surgical risk. Transcatheter mitral valve repair using a percutaneous edge-to-edge technique is the most widely available choice at present...
September 2018: Canadian Journal of Cardiology
Piera Capranzano, Nicolas M Van Mieghem, Corrado Tamburino
Aortic stenosis and mitral regurgitation are increasingly treated by percutaneous interventions including transcatheter aortic valve implantation (TAVI) and several mitral valve repair techniques, changing the landscape of valvular therapies in which surgery was predominant. Several randomised studies on TAVI have led to the use of this procedure in patients at intermediate or higher operative risk and have set strong foundations for future trials aiming to expand indications or to overcome several residual issues with TAVI...
August 31, 2018: EuroIntervention
Jean-François Obadia, David Messika-Zeitoun, Guillaume Leurent, Bernard Iung, Guillaume Bonnet, Nicolas Piriou, Thierry Lefèvre, Christophe Piot, Frédéric Rouleau, Didier Carrié, Mohammed Nejjari, Patrick Ohlmann, Florence Leclercq, Christophe Saint Etienne, Emmanuel Teiger, Lionel Leroux, Nicole Karam, Nicolas Michel, Martine Gilard, Erwan Donal, Jean-Noël Trochu, Bertrand Cormier, Xavier Armoiry, Florent Boutitie, Delphine Maucort-Boulch, Cécile Barnel, Géraldine Samson, Patrice Guerin, Alec Vahanian, Nathan Mewton
Background In patients who have chronic heart failure with reduced left ventricular ejection fraction, severe secondary mitral-valve regurgitation is associated with a poor prognosis. Whether percutaneous mitral-valve repair improves clinical outcomes in this patient population is unknown. Methods We randomly assigned patients who had severe secondary mitral regurgitation (defined as an effective regurgitant orifice area of >20 mm2 or a regurgitant volume of >30 ml per beat), a left ventricular ejection fraction between 15 and 40%, and symptomatic heart failure, in a 1:1 ratio, to undergo percutaneous mitral-valve repair in addition to receiving medical therapy (intervention group; 152 patients) or to receive medical therapy alone (control group; 152 patients)...
August 27, 2018: New England Journal of Medicine
Timothy A Joseph, Colleen E Lane, Erin A Fender, Chad J Zack, Charanjit S Rihal
Significant paravalvular leak (PVL) complicates between 6% and 15% of valve replacements and can result in heart failure and hemolysis. Paravalvular leak can be effectively treated with repeat surgery; however, these procedures are associated with significant operative morbidity. Percutaneous PVL closure is increasingly being utilized as the first line therapy for symptomatic patients, but efficacy may be limited by the lack of dedicated closure devices. Areas covered: This article will review the etiology and prevalence of PVL, discuss outcomes with surgical closure, describe the mounting data supporting percutaneous interventions, and highlight areas for future research emphasizing the need for new dedicated closure devices...
August 21, 2018: Expert Review of Medical Devices
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...
October 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
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