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Transcatheter mitral valve replacement

Heike Baumgarten, John J Squiers, William T Brinkman, J Michael DiMaio, Ambarish Gopal, Michael J Mack, Robert L Smith
Mitral annular calcification (MAC) is a chronic degenerative process at the fibrous base of the mitral valve. It is a feared diagnosis in the context of mitral valve operations because of the risk of severe adverse events such as atrioventricular disruption, injury to the circumflex artery during debridement, and difficult placement of annular sutures. We report a series of 3 consecutive female patients with severe circular MAC who underwent successful mitral valve replacement through a lateral minithoracotomy with use of an inverted transcatheter aortic valve...
November 2016: Annals of Thoracic Surgery
Hellmuth Weich, Jacques Janson, Alfonso Pecoraro, Jacques van Wyk, Andre Rocher, Johan Dempers, Anton Doubell
No abstract text is available yet for this article.
October 20, 2016: EuroIntervention
Philip Y K Pang, Jiasi Zhu, Yoong Kong Sin, Yeow Leng Chua
Most mitral paravalvular leaks (PVLs) occur during the first year after mitral valve replacement (MVR). This report describes the surgical management of 6 patients who developed very late mitral PVLs. The median interval between MVR and initial diagnosis of PVL was 16.5 years. All patients presented with congestive cardiac failure and haemolytic anaemia. The median EuroSCORE II was 9.5%. Two patients (33%) had failed attempts at transcatheter closure. Five patients underwent suture repair of the PVL. One patient underwent MVR after removal of the previous prosthesis...
September 2016: Journal of Thoracic Disease
Sten Lyager Nielsen
Transcatheter mitral valve (MV) intervention has emerged as an effective treatment option for symptomatic severe mitral regurgitation (MR) in patients considered to be inoperable or at high operative risk for surgical MV surgery. In primary mitral regurgitation, surgical repair is the standard of care. Transcatheter edge-to-edge MV repair with the MitraClip system has the largest clinical experience to date, and offers a sustained clinical benefit in selected surgical high-risk patients. Surgery for secondary MR remains a challenge...
October 13, 2016: Scandinavian Cardiovascular Journal: SCJ
Bettina Langhammer, Christoph Huber, Stephan Windecker, Thierry Carrel
Surgical techniques for the treatment of mitral valve disease (MVD) have continuously evolved; however, anatomical details like severe annular calcification remain challenging and require sophisticated surgical strategies. Among patients with symptomatic MVD referred for surgical valve repair or replacement, four presented with circumferential calcification of the mitral annulus precluding conventional surgical techniques. Successful treatment by implanting a balloon-expandable transcatheter aortic heart valve using an antegrade surgical access was performed...
September 27, 2016: European Journal of Cardio-thoracic Surgery
Michal Hulman, Martin Bena, Panagiotis Artemiou, Ivo Gasparovic, Vladan Hudec, Ronak Rajani, Vinayak Bapat
Transcatheter mitral valve replacement using balloon-expandable valves is an emerging technique for the treatment of patients with significant mitral regurgitation who have been judged to be inoperable owing to significant mitral valve annulus calcification. Although initial reports have been promising, there remains a lack of consensus as to how to plan for transcatheter mitral valve replacement deployment in terms of appropriateness, sizing, and positioning to mitigate the risks of valve displacement and paravalvular regurgitation...
October 2016: Annals of Thoracic Surgery
Maurizio Taramasso, Shingo Kuwata, Hector Rodriguez Cetina Biefer, Fabian Nietlispach, Francesco Maisano
As transcatheter mitral replacement technologies have recently been applied in early clinical trials, the question as to whether valve implantation would have the potential to become the leading percutaneous mitral valve therapy has been raised. The aim of this report is to give an overview of the different peculiarities of percutaneous replacement and repair techniques, and to predict whether the two approaches will have a complementary rather than a competitive clinical role in the near future.
September 18, 2016: EuroIntervention
Rüdiger Lange, Nicolo Piazza
No abstract text is available yet for this article.
September 18, 2016: EuroIntervention
Ian Meredith, Vinayak Bapat, John Morriss, Matt McLean, Bernard Prendergast
No abstract text is available yet for this article.
September 18, 2016: EuroIntervention
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
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
Fatima I Lunze, Babar S Hasan, Kimberlee Gauvreau, David W Brown, Steven D Colan, Doff B McElhinney
BACKGROUND: Relief of postoperative right ventricular outflow tract (RVOT) obstruction with transcatheter pulmonary valve replacement (TPVR) results in functional improvement in the short term which we investigated at baseline (BL), early follow-up (FU), and midterm FU after TPVR. METHODS: Echocardiography and cardiopulmonary exercise testing were performed at BL and at early (median 6 months) and midterm FU (median 2.5years) after TPVR. RESULTS: Patients with RVOT obstruction (n=22, median age 17years) were studied...
September 2016: American Heart Journal
Francesco Saia, Carolina Moretti, Gianni Dall'Ara, Cristina Ciuca, Nevio Taglieri, Alessandra Berardini, Pamela Gallo, Marina Cannizzo, Matteo Chiarabelli, Niccolò Ramponi, Linda Taffani, Maria Letizia Bacchi-Reggiani, Cinzia Marrozzini, Claudio Rapezzi, Antonio Marzocchi
BACKGROUND: Whilst the majority of the patients with severe aortic stenosis can be directly addressed to surgical aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), in some instances additional information may be needed to complete the diagnostic workout. We evaluated the role of balloon aortic valvuloplasty (BAV) as a bridge-to-decision (BTD) in selected high-risk patients. METHODS: Between 2007 and 2012, the heart team in our Institution required BTD BAV in 202 patients...
September 2016: Journal of Geriatric Cardiology: JGC
Takanari Fujita, Naritatsu Saito, Kenji Minakata, Masao Imai, Kazuhiro Yamazaki, Takeshi Kimura
An 82-year-old woman with severe aortic stenosis was referred. She had previously undergone mitral valve replacement. We planned transcatheter aortic valve implantation (TAVI) with transfemoral approach. We planned to use the Safari-dedicated TAVI guidewire. No studies have reported clinical application of the dedicated TAVI guidewire in a patient with the previous mitral valve replacement. Thus, we conducted a simulation using a three-dimensional heart model to confirm the safety of the procedure. The procedure was successful without any complications...
August 27, 2016: Cardiovascular Intervention and Therapeutics
Gry Dahle, Kjell Arne Rein, Arnt E Fiane
A 73-year-old woman underwent open mitral valve replacement with the transcatheter Edwards SAPIEN XT valve (Edwards Lifesciences, Corp, Irvine, CA USA) on cardiopulmonary bypass in a native, stenotic mitral valve. Because of left ventricular outflow tract obstruction, the patient died 25 days after implantation. There are previous reports of transcatheter valve implantation in native mitral valve with procedural success. However, in one case report, the patient died 10 days postoperatively.
July 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
Sarkis Kiramijyan, Marco A Magalhaes, Edward Koifman, Romain Didier, Ricardo O Escarcega, Sa'ar Minha, Nevin C Baker, Smita I Negi, Rebecca Torguson, Jiaxiang Gai, Petros Okubagzi, Federico M Asch, Michael A Gaglia, Itsik Ben-Dor, Lowell F Satler, Augusto D Pichard, Ron Waksman
BACKGROUND: The prevalence of concomitant significant mitral regurgitation (MR) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) ranges from 2% to 33%. The impact of significant MR on post-TAVR outcomes remains controversial. METHODS: The data from a cohort of patients with symptomatic severe AS undergoing TAVR at out institution were retrospectively analyzed. The last transthoracic echocardiogram (TTE) before the index TAVR procedure was selected as the baseline assessment of the degree of MR...
August 2016: American Heart Journal
Takashi Murakami, Hiromichi Fujii, Masanori Sakaguchi, Yosuke Takahashi, Yasuo Suehiro, Shinsuke Nishimura, Yoshito Sakon, Daisuke Yasumizu, Etsuji Sohgawa, Toshihiko Shibata
Transcatheter closure of paravalvular leaks requires precise assessment of the location, size, and shape of the defect. Transesophageal echocardiography plays an important role in this process. We encountered a case of a paravalvular leak at the aortic position after aortic and mitral valve replacement. It was impossible to detect the precise location of the paravalvular leak with transesophageal echocardiography because of an acoustic shadow from the mitral mechanical valve. Intraoperative use of intravascular ultrasound was useful for determining the morphology of the defect and evaluating the procedure during the operation...
August 8, 2016: General Thoracic and Cardiovascular Surgery
Kreton Mavromatis
No abstract text is available yet for this article.
August 8, 2016: JACC. Cardiovascular Interventions
Carlos Cortés, Ignacio J Amat-Santos, Luis Nombela-Franco, Antonio J Muñoz-Garcia, Enrique Gutiérrez-Ibanes, José M De La Torre Hernandez, Juan G Córdoba-Soriano, Pilar Jimenez-Quevedo, José M Hernández-García, Ana Gonzalez-Mansilla, Javier Ruano, Jesús Jimenez-Mazuecos, Javier Castrodeza, Javier Tobar, Fabian Islas, Ana Revilla, Rishi Puri, Ana Puerto, Itziar Gómez, Josep Rodés-Cabau, José A San Román
OBJECTIVES: This study sought to analyze the clinical impact of the degree and improvement of mitral regurgitation in TAVR recipients, validate the main imaging determinants of this improvement, and assess the potential candidates for double valve repair with percutaneous techniques. BACKGROUND: Many patients with severe aortic stenosis present with concomitant mitral regurgitation (MR). Cardiac imaging plays a key role in identifying prognostic factors of MR persistence after transcatheter aortic valve replacement (TAVR) and for planning its treatment...
August 8, 2016: JACC. Cardiovascular Interventions
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