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David W M Muller, Robert Saeid Farivar, Paul Jansz, Richard Bae, Darren Walters, Andrew Clarke, Paul A Grayburn, Robert C Stoler, Gry Dahle, Kjell A Rein, Marty Shaw, Gregory M Scalia, Mayra Guerrero, Paul Pearson, Samir Kapadia, Marc Gillinov, Augusto Pichard, Paul Corso, Jeffrey Popma, Michael Chuang, Philipp Blanke, Jonathon Leipsic, Paul Sorajja
BACKGROUND: Symptomatic mitral regurgitation (MR) is associated with high morbidity and mortality that can be ameliorated by surgical valve repair or replacement. Despite this, many patients with MR do not undergo surgery. Transcatheter mitral valve replacement (TMVR) may be an option for selected patients with severe MR. OBJECTIVES: This study aimed to examine the effectiveness and safety of TMVR in a cohort of patients with native valve MR who were at high risk for cardiac surgery...
December 20, 2016: Journal of the American College of Cardiology
Pradeep Yadav, Dee Dee Wang, Marvin Eng, Adam Greenbaum, William O'Neill
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
Mathias Orban, Martin Orban, Daniel Braun, Michael Näbauer, Steffen Massberg, Jörg Hausleiter
Heart failure and severe mitral regurgitation (MR) are mutually dependent. Secondary MR is a consequence of chronic heart failure in patients with severely depressed left ventricular ejection fraction (LV-EF) and LV dilatation. Severe MR in heart failure patients worsens prognosis and accelerates LV dilatation and decline in LV-EF. Interventional therapies have changed clinical practice for heart failure patients with secondary MR. In this review we summarize the available data of patients with chronic heart failure undergoing transcatheter edge-to-edge mitral valve repair (TMVR) with the MitraClip® system for severe secondary mitral regurgitation...
December 13, 2016: Minerva Cardioangiologica
Eun Y Lee, Young G Hwang, Hyun S Lee
Based on the importance of tuberomammillary nucleus (TMN) as a target for feeding/arousal-related functions, we aimed in the present study to investigate hypothalamic neuronal origin of neuropeptide Y (NPY) and cocaine- and amphetamine-regulated transcript (CART) fibers projecting to the histaminergic nucleus. In the first series of experiments, we examined NPY (or CART) fiber distribution within the boundary of adenosine deaminase (ADA)-immunoreactive (ir) TMN regions; extensive NPY (or CART)-ir axon terminals were observed in E4 (TMMd), E3 (TMMv), and E2 (TMVr) subdivisions...
December 3, 2016: Brain Research
Amar Krishnaswamy, Stephanie Mick, Jose Navia, A Marc Gillinov, E Murat Tuzcu, Samir R Kapadia
As transcatheter aortic valve replacement (TAVR) has become routine, device manufacturers and investigational cardiologists have set their sights on the mitral valve. Although transcatheter mitral valve replacement (TMVR) poses several technical challenges, they appear to be surmountable, and work is proceeding. Here we review the various devices being developed and preliminary results of trials in humans.
November 2016: Cleveland Clinic Journal of Medicine
Mackram F Eleid, Guy S Reeder, Joseph F Malouf, Ryan J Lennon, Sorin V Pislaru, Vuyisille T Nkomo, Charanjit S Rihal
OBJECTIVES: This study sought to assess the learning curve for TMVR for treatment of primary mitral regurgitation (MR). BACKGROUND: Data are lacking regarding the technical experience required to achieve optimal clinical outcomes with transcatheter mitral valve repair (TMVR) using the edge-to-edge MitraClip technique. METHODS: We examined the sequential experience of the first 75 patients (age 80 ± 9 years; 77% male) who underwent TMVR at our institution...
October 2016: Journal of Interventional Cardiology
Jonathon Leipsic, Philipp Blanke
The treatment of both aortic and now mitral valvular disease has been transformed through transcatheter valvular interventions. TAVR has rapidly become the treatment of choice for symptomatic severe aortic stenosis in both high, and now intermediate-risk patients. Building upon this success the last two years have seen the clinical introduction of transcatheter mitral valve replacement (TMVR), with a number of devices being utilised in first-in-man and feasibility studies. These experiences have helped determine the anatomical requirements and specifications that enable successful device deployment and avoidance of complications...
September 18, 2016: EuroIntervention
Can Öztürk, Robert Schueler, Marcel Weber, Armin Welz, Nikos Werner, Georg Nickenig, Christoph Hammerstingl
OBJECTIVES: This study shows the impact of secondary mitral regurgitation (sMR) and transcatheter mitral valve repair (TMVR) with the MitraClip system on sympathetic nerve activity (SNA). BACKGROUND: An increase in SNA is associated with worse outcomes and limited survival in patients with chronic heart failure (CHF). METHODS: Twenty CHF-patients without relevant sMR and 30 CHF patients with symptomatic sMR were enrolled prospectively. All patients underwent standardized laboratory testing and microneurography...
October 10, 2016: JACC. Cardiovascular Interventions
Jaffar M Khan, Toby Rogers, William H Schenke, Jonathan R Mazal, Anthony Z Faranesh, Adam B Greenbaum, Vasilis C Babaliaros, Marcus Y Chen, Robert J Lederman
OBJECTIVES: The authors propose a novel transcatheter transection of the anterior mitral leaflet to prevent iatrogenic left ventricular outflow tract (LVOT) obstruction during transcatheter mitral valve replacement (TMVR). BACKGROUND: LVOT obstruction is a life-threatening complication of TMVR caused by septal displacement of the anterior mitral leaflet. METHODS: In vivo procedures in swine were guided by biplane x-ray fluoroscopy and intracardiac echocardiography...
September 12, 2016: JACC. Cardiovascular Interventions
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
Mohammad Abdelghani, Ernest Spitzer, Osama I I Soliman, Dietrich Beitzke, Roberta Laggner, Rafael Cavalcante, Hiroki Tateishi, Carlos M Campos, Luc Verstraeten, Yohei Sotomi, Erhan Tenekecioglu, Yoshinobu Onuma, Jan G Tijssen, Robbert J de Winter, Francesco Maisano, Patrick W Serruys
AIMS: Transcatheter mitral valve replacement (TMVR) provides definitive valve replacement through a minimally invasive procedure. In the setting of TMVR, it remains unclear how relevant the differences between different mitral annular (MA) diameters are. We sought to define a simplified and reproducible method to describe the MA size. METHODS AND RESULTS: Using cardiac computed tomography angiography (CTA) studies of 47 patients, 3D MA perimeter (P3D) was annotated...
June 26, 2016: European Heart Journal Cardiovascular Imaging
Dee Dee Wang, Marvin Eng, Adam Greenbaum, Eric Myers, Michael Forbes, Milan Pantelic, Thomas Song, Christina Nelson, George Divine, Andrew Taylor, Janet Wyman, Mayra Guerrero, Robert J Lederman, Gaetano Paone, William O'Neill
No abstract text is available yet for this article.
November 2016: JACC. Cardiovascular Imaging
Basel Ramlawi, James S Gammie
The mitral valve is a highly complex structure, the competency and function of which relies on the harmonious action of its component parts. Minimally invasive cardiac surgery (MICS) for mitral valve repair or replacement (MVR/r) has been performed successfully with incremental improvements in techniques over the past decade. These minimally invasive procedures, while attractive to patients and referring physicians, should meet the same high bar for optimal clinical outcomes and long-term durability of valve repair as traditional sternotomy procedures...
January 2016: Methodist DeBakey Cardiovascular Journal
Mayra Guerrero, Marina Urena, Amit Pursnani, Dee D Wang, Alec Vahanian, William O'Neill, Ted Feldman, Dominique Himbert
Patients with mitral annular calcification (MAC) have high surgical risk for mitral valve replacement due to associated comorbidities and technical challenges related to calcium burden, precluding surgery in many patients. Transcatheter mitral valve replacement (TMVR) with the compassionate use of balloon expandable aortic transcatheter heart valves has been used in this clinical scenario. The purpose of this review was to summarize the early experience including successes and failures reported. TMVR might evolve into an acceptable alternative for selected patients with severe MAC who are not candidates for conventional mitral valve surgery...
June 2016: Journal of Cardiovascular Surgery
Navin Natarajan, Parag Patel, Thomas Bartel, Samir Kapadia, Jose Navia, William Stewart, E Murat Tuzcu, Paul Schoenhagen
Mitral regurgitation (MR) has a high prevalence in older patient populations of industrialized nations. Common etiologies are structural, degenerative MR and functional MR secondary to myocardial remodeling. Because of co-morbidities and associated high surgical risk, open surgical mitral repair/replacement is deferred in a significant percentage of patients. For these patients transcatheter repair/replacement are emerging as treatment options. Because of the lack of direct visualization, pre- and intra-procedural imaging is critical for these procedures...
April 2016: Cardiovascular Diagnosis and Therapy
Heike Baumgarten, John J Squiers, Mani Arsalan, M John, Michael J Dimaio
Mitral regurgitation (MR) can be divided into two major etiologies, primary and secondary MR. Primary MR, also termed degenerative or organic MR, is a disease of the valve itself and is treated routinely by surgical repair in all but prohibitive risk patients. In these patients, transcatheter repair techniques, including edge to edge repair with the MitraClip device have been largely successful and widely adopted. Transcatheter placement of artificial chords has also been performed. The potential role for transcatheter mitral valve replacement (TMVR) in primary MR will likely be quite limited...
June 2016: Journal of Cardiovascular Surgery
Akhil Narang, Mayra Guerrero, Ted Feldman, Amit Pursnani
Multidetector cardiac computerized tomography (CT) is a robust advanced imaging modality with high spatial resolution that has emerged as an essential tool for the planning of structural heart and electrophysiology interventions. The most notable example has been its important role in the pre-procedural planning of transcatheter aortic valve replacement (TAVR), which has developed to the point that commercial software packages are commonly used for this application. More recently several novel approaches and devices have been developed for transcatheter mitral valve replacement (TMVR)...
June 2016: Journal of Cardiovascular Surgery
Amos Levi, Alexander Sagie, Ran Kornowski
Systolic anterior motion (SAM) of the anterior mitral leaflet is a well reported complication of surgical mitral valve repair (MVR). In the current report, we present a case of SAM with left ventricular outflow tract obstruction (LVOTO) which occurred after transcatheter mitral valve repair (TMVR) using the MitraClip device. LVOTO was caused by the combination of protrusion of the MitraClip device into the LVOT and underfilling of the left ventricle due to pericardial effusion and atrial fibrillation. Rapid clinical resolution and marked decline in LVOT pressure gradient occurred following surgical drainage and windowing of the pericardium...
March 4, 2016: Catheterization and Cardiovascular Interventions
Pascal Thériault-Lauzier, Magdalena Dorfmeister, Darren Mylotte, Ali Andalib, Marco Spaziano, Philipp Blanke, Giuseppe Martucci, Rüdiger Lange, Jonathon Leipsic, Luc Bilodeau, Nicolo Piazza
AIMS: Transcatheter mitral valve replacement (TMVR) is an emerging technology with the potential to treat patients with mitral regurgitation at excessive risk for mitral valve surgery. Geometrical measurements of the mitral valvular complex may have implications for the design of TMVR devices and for patient selection. This study sought to quantify the dynamic geometry of the mitral valvular complex in patients with significant functional mitral regurgitation (FMR) using multi-slice computed tomography (MSCT)...
October 10, 2016: EuroIntervention
Pascal Thériault-Lauzier, Darren Mylotte, Magdalena Dorfmeister, Marco Spaziano, Ali Andalib, Samuel Mamane, Michael Chetrit, Philipp Blanke, Renzo Cecere, Jean Buithieu, Giuseppe Martucci, Didier Tchetche, Thomas Modine, Nicolas van Mieghem, Rüdiger Lange, Stephan Windecker, Luc Bilodeau, Jonathon Leipsic, Nicolo Piazza
AIMS: Transcatheter mitral valve replacement (TMVR) is an emerging technology with the potential to treat patients with severe mitral regurgitation at excessive risk for surgical mitral valve surgery. Multimodality imaging of the mitral valvular complex and surrounding structures will be an important component for patient selection for TMVR. Our aim was to describe and evaluate a systematic multi-slice computed tomography (MSCT) image analysis methodology that provides measurements relevant for transcatheter mitral valve replacement...
October 10, 2016: EuroIntervention
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