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Rajkumar Doshi, Evan Shlofmitz, Jay Shah, Perwaiz Meraj
Transcatheter mitral valve repair (TMVR) is an emerging treatment modality that has been reserved for high-risk patients with multiple co-morbidities. We hypothesize that TMVR is a safe and effective procedure for patients with moderate to severe mitral regurgitation who are not surgical candidates. The National Inpatient Sample (2012 to 2014) using the International Classification of Diseases, 9th Revision, Clinical Modification procedure codes 35.97 for TMVR and 35.12 for surgical mitral valve repair (SMVR) were used...
December 25, 2017: American Journal of Cardiology
Abdallah El Sabbagh, Mackram F Eleid, Jane M Matsumoto, Nandan S Anavekar, Mohammed A Al-Hijji, Sameh M Said, Vuyisile T Nkomo, David R Holmes, Charanjit S Rihal, Thomas A Foley
INTRODUCTION: Three-dimensional (3D) prototyping is a novel technology which can be used to plan and guide complex procedures such as transcatheter mitral valve replacement (TMVR). METHODS: Eight patients with severe mitral annular calcification (MAC) underwent TMVR. 3D digital models with digital balloon expandable valves were created from pre-procedure CT scans using dedicated software. Five models were printed. These models were used to assess prosthesis sizing, anchoring, expansion, paravalvular gaps, left ventricular outflow tract (LVOT) obstruction, and other potential procedure pitfalls...
January 23, 2018: Catheterization and Cardiovascular Interventions
Jeremy J Thaden, Joseph F Malouf, Vuyisile T Nkomo, Sorin V Pislaru, David R Holmes, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge-to-edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip. METHODS AND RESULTS: Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics...
January 13, 2018: Journal of the American Heart Association
Gialama Fotini, Prezerakos Panagiotis, Apostolopoulos Vasilis, Nikolaos Maniadakis
Objectives: Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. Methods: The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach...
January 9, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
Michael Mack, Robert Smith
No abstract text is available yet for this article.
January 2, 2018: Journal of the American College of Cardiology
Dee Dee Wang, Marvin H Eng, Adam B Greenbaum, Eric Myers, Michael Forbes, Patrick Karabon, Milan Pantelic, Thomas Song, Jeff Nadig, Mayra Guerrero, William W O'Neill
OBJECTIVE: Demonstrate proof-of-concept validation of a computed tomography (CT) computer-aided design prediction modeling tool to identify patients at risk for left ventricular outflow tract (LVOT) obstruction in transcatheter mitral valve replacement (TMVR). BACKGROUND: LVOT obstruction is a significant and even fatal consequence of TMVR. METHODS: From August 2013 to August 2017, 38 patients in 5 centers underwent TMVR with compassionate use of balloon-expandable valves for severe mitral valve dysfunction because of degenerative surgical mitral ring, bioprosthesis, or severe native mitral stenosis from to severe mitral annular calcification...
December 11, 2017: Catheterization and Cardiovascular Interventions
Azeem Latib, Juan Granada
No abstract text is available yet for this article.
December 8, 2017: EuroIntervention
Mackram F Eleid, Guy S Reeder, Charanjit S Rihal
OBJECTIVE: The objective of this study was to determine the accuracy of left atrial pressure (LAP) measurement through the manufacturer provided steerable guiding catheter (SGC) during transcatheter mitral valve repair (TMVR). BACKGROUND: LAP measurement during TMVR has been shown to be associated with clinical improvement when measured through a dedicated catheter. METHODS: Simultaneous LAP was performed in consecutive patients using an independent fluid-filled 4F multipurpose catheter and compared to LAP waveforms measured through the manufacturer-provided MitraClip SGC during TMVR (Abbott, Santa Clara, CA)...
November 24, 2017: Catheterization and Cardiovascular Interventions
Zaher Fanari, Hadi Mahmaljy, Shalish Nandish, Nilesh J Goswami
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management...
November 6, 2017: Catheterization and Cardiovascular Interventions
Vinayak Bapat, Vivek Rajagopal, Christopher Meduri, R Saeid Farivar, Antony Walton, Stephen J Duffy, Robert Gooley, Aubrey Almeida, Michael J Reardon, Neal S Kleiman, Konstantinos Spargias, Stratis Pattakos, Martin K Ng, Michael Wilson, David H Adams, Martin Leon, Michael J Mack, Sharla Chenoweth, Paul Sorajja
BACKGROUND: Transcatheter mitral valve replacement (TMVR) is a potential therapy for patients with symptomatic, severe mitral regurgitation (MR). The feasibility of this therapy remains to be defined. OBJECTIVES: The authors report their early experience with TMVR using a new valve system. METHODS: The valve is a self-expanding, nitinol valve with bovine pericardial leaflets that is placed using a transapical delivery system. Patients with symptomatic MR who were deemed high or extreme risk by the local heart teams were enrolled in a global pilot study at 14 sites (United States, Australia, and Europe)...
January 2, 2018: Journal of the American College of Cardiology
Steven F Bolling
No abstract text is available yet for this article.
November 7, 2017: Journal of the American College of Cardiology
Marina Urena, Dominique Himbert, Eric Brochet, Jose Luis Carrasco, Bernard Iung, Patrick Nataf, Alec Vahanian
Transcatheter mitral valve replacement (TMVR) using balloon-expandable valves has become an alternative therapy for selected patients with mitral valve disease. Up to now, the transapical approach has been the preferred route, but the transseptal approach is becoming increasingly popular due to its reduced invasiveness and increased safety. However, transseptal TMVR procedures are technically challenging, and little is known about the screening process required before this therapy. The authors provide operators with a step-by-step approach from the screening process to follow-up care for transseptal TMVR procedures...
October 9, 2017: JACC. Cardiovascular Interventions
John Mooney, Stephanie L Sellers, Mickaël Ohana, João L Cavalcante, Chesnal D Arepalli, Rominder Grover, Ung Kim, Kapilan Selvakumar, Philipp Blanke, Jonathon A Leipsic
The success and continued rapid clinical integration of transcatheter valve technologies relies on imaging modalities to guide safe and effective device deployment. In particular, cardiac imaging, using both echocardiography and CT, is an integral resource for the multidisciplinary team. These modalities can provide valuable insight for the proceduralist at each stage of transcatheter-based valve insertion, as they can be used reliably to define the anatomy of interest and its relationship to surrounding structures, determine accurate device sizing, assess patients for valve-in-valve procedures, and screen for adverse features or procedural contraindications...
September 24, 2017: EuroIntervention
Amisha Patel, Vinayak Bapat
Mitral regurgitation (MR) is the second most common valvular heart disease in the western world with a prevalence in the USA alone of two to four million people. MR is age-dependent and hence the MR burden is expected to increase with the increase in life expectancy observed in Europe and the USA. Medical and surgical treatment has been the cornerstone of the treatment as untreated MR results in poor prognosis. However, only a fraction of patients are offered surgical treatment due to high risk. With the success of transcatheter aortic valve implantation (TAVI), many transcatheter options have emerged to provide a less invasive option for these patients...
September 24, 2017: EuroIntervention
Theresa Herbrand, Silke Eschenhagen, Tobias Zeus, Eva Kehmeier, Katharina Hellhammer, Verena Veulemans, Malte Kelm, Jan Balzer
BACKGROUND: Transcatheter mitral valve repair (TMVR) has been shown to have acute effects on mitral valve geometry in patients with functional mitral regurgitation (FMR). This study investigates the impact of MitraClip(®) therapy-induced annular remodeling on clinical outcome and mitral regurgitation in heart failure patients. METHODS: TMVR was performed successfully in 45 patients with FMR. In this study, mitral valve datasets were obtained before and directly after MitraClip(®) implantation using three-dimensional (3D) transesophageal echocardiography, and were analyzed offline retrospectively using dedicated 3D reconstruction software...
September 20, 2017: European Journal of Medical Research
Tomo Ando, Hisato Takagi, Alexandros Briasoulis, Tesfaye Telila, David P Slovut, Luis Afonso, Cindy L Grines, Theodore Schreiber
OBJECTIVES: To summarize the published data of combined transcatheter aortic and mitral valve intervention (CTAMVI). BACKGROUND: CTAMVI, a combination of either transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve-in-valve (TAViV) and transcatheter mitral valve replacement (TMVR), transcatheter mitral valve-in-valve/valve-in-ring (TMViV/ViR), or percutaneous mitral valve repair (PMVR) is an attractive alternative in high-surgical risk patients with combined aortic and mitral valve disease...
September 1, 2017: Catheterization and Cardiovascular Interventions
Ander Regueiro, Jian Ye, Neil Fam, Vinayak N Bapat, François Dagenais, Mark D Peterson, Stephan Windecker, John G Webb, Josep Rodés-Cabau
OBJECTIVES: This study sought to determine late (2-year) outcomes following transcatheter mitral valve replacement (TMVR) with the FORTIS valve (Edwards Lifesciences, Irvine, California). BACKGROUND: No data exist on long-term clinical outcomes following TMVR in patients with severe native mitral regurgitation (MR). METHODS: This multicenter registry included consecutive patients with severe MR who underwent TMVR with the FORTIS valve under a compassionate clinical use program...
August 28, 2017: JACC. Cardiovascular Interventions
Sung-Han Yoon, Brian K Whisenant, Sabine Bleiziffer, Victoria Delgado, Niklas Schofer, Lena Eschenbach, Buntaro Fujita, Rahul Sharma, Marco Ancona, Ermela Yzeiraj, Stefano Cannata, Colin Barker, James E Davies, Antonio H Frangieh, Florian Deuschl, Tomaz Podlesnikar, Masahiko Asami, Abhijeet Dhoble, Anthony Chyou, Jean-Bernard Masson, Harindra C Wijeysundera, Daniel J Blackman, Rajiv Rampat, Maurizio Taramasso, Enrique Gutierrez-Ibanes, Tarun Chakravarty, Guiherme F Attizzani, Tsuyoshi Kaneko, S Chiu Wong, Horst Sievert, Fabian Nietlispach, David Hildick-Smith, Luis Nombela-Franco, Lenard Conradi, Christian Hengstenberg, Michael J Reardon, Albert Markus Kasel, Simon Redwood, Antonio Colombo, Saibal Kar, Francesco Maisano, Stephan Windecker, Thomas Pilgrim, Stephan M Ensminger, Bernard D Prendergast, Joachim Schofer, Ulrich Schaefer, Jeroen J Bax, Azeem Latib, Raj R Makkar
BACKGROUND: Limited data exist regarding transcatheter mitral valve replacement (TMVR) for patients with failed mitral valve replacement and repair. OBJECTIVES: This study sought to evaluate the outcomes of TMVR in patients with failed mitral bioprosthetic valves (valve-in-valve [ViV]) and annuloplasty rings (valve-in-ring [ViR]). METHODS: From the TMVR multicenter registry, procedural and clinical outcomes of mitral ViV and ViR were compared according to Mitral Valve Academic Research Consortium criteria...
August 29, 2017: Journal of the American College of Cardiology
Fabien Praz, Konstantinos Spargias, Michael Chrissoheris, Lutz Büllesfeld, Georg Nickenig, Florian Deuschl, Robert Schueler, Neil P Fam, Robert Moss, Moody Makar, Robert Boone, Jeremy Edwards, Aris Moschovitis, Saibal Kar, John Webb, Ulrich Schäfer, Ted Feldman, Stephan Windecker
BACKGROUND: Severe mitral regurgitation is associated with impaired prognosis if left untreated. Using the devices currently available, transcatheter mitral valve repair (TMVr) remains challenging in complex anatomical situations. We report the procedural and 30-day results of the first-in-man study of the Edwards PASCAL TMVr system. METHODS: In this multicentre, prospective, observational, first-in-man study, we collected data from seven tertiary care hospitals in five countries that had a compassionate use programme in which patients underwent transcatheter mitral valve repair using the Edwards PASCAL TMVr system...
August 19, 2017: Lancet
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