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Transcatheter mitral valve replacement

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https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#1
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28606165/pitfalls-in-tamvi-experience-with-the-repositionable-lotus%C3%A2-valve-system
#2
Paul P Heinisch, Fabien Praz, Bernhard Winkler, Stephan Windecker, Christoph Huber, Thierry Carrel
BACKGROUND: Simultaneous transapical implantation of transcatheter heart valves in the native mitral and aortic position may be considered as an alternative to surgical valve replacement in high-risk patients presenting with combined valve disease. CASE PRESENTATION: A 59-year-old female with severe aortic stenosis, severe mitral stenosis with mild mitral insufficiency, persistent atrial fibrillation, severe chronic obstructive pulmonary disease and NYHA class of IV was evaluated by our interdisciplinary heart team...
June 12, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28600091/transcatheter-aortic-valve-replacement-and-mitraclip-to-reverse-heart-failure
#3
REVIEW
Sukhdeep Basra, Molly Szerlip
Valvular heart diseases such as aortic stenosis and mitral regurgitation are often associated with heart failure, which in turn increases patients' Surgical Thoracic Society (STS) score. A high STS score means the patient is high risk for surgical aortic valve replacement and mitral valve repair/replacement. Transcatheter aortic valve replacement and percutaneous mitral valve repair offer a minimally invasive alternative for the treatment of valvular heart disease in patients with severe heart failure. We aim to review the current evidence on the safety, efficacy, and outcomes of these devices in patients with severe heart failure...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28597998/a-novel-mechanical-mitral-valve-replacement-using-sapien-xt
#4
Megan Koehle, Justin A Strote, Mark Guadagnoli, J Bradley Oldemeyer
PATIENT PRESENTATION: We report the case of a 66 year old female who presented to our institution fourteen years after receiving a St. Jude Mechanical Mitral Valve Replacement. She presented in refractory NYHA class IV congestive heart failure with comorbidities of acute renal failure, liver failure, and mental status changes. She was found to have immobility of one of the mitral valve disks with resultant severe mitral stenosis with a mean pressure gradient of 12 mmHg. EVALUATION AND MANAGEMENT: The patient was found to have an STS predicted mortality of 39% with redo surgical MVR, and evaluation by the valve team led to a recommendation of a hybrid surgical and transcatheter procedure...
June 9, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28566474/mitral-valve-repair-for-degenerative-mitral-valve-disease-surgical-approach-patient-selection-and-long-term-outcomes
#5
REVIEW
Gonçalo F Coutinho, Manuel J Antunes
Mitral valve repair (MVRepair) has become the procedure of choice to correct severe degenerative mitral regurgitation (MR), due to its documented superiority to valve replacement regarding long-term survival, freedom from valve-related adverse events and preservation of left ventricular (LV) function. The refinement of MVRepair techniques has rendered almost all valves (more than 95%) amenable to repair with a 15-year freedom from reoperation of 90%. The concept of 'centres of excellence for MVRepair' has emerged, encouraging referring doctors to select the most experienced institutions or individual surgeons to deal with the most complex cases, based on repair volume, appropriate peri-procedural imaging and data regarding expected outcomes (repair, mortality and durability of repair)...
May 31, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28566291/transcatheter-mitral-valve-replacement-with-a-novel-dual-stent-bioprosthesis
#6
Benjamin M Moore, H K Bernard Ng, Christopher Naoum, Lisa Simmons, Bruce L Cartwright, Michael K Wilson, Martin K C Ng
No abstract text is available yet for this article.
June 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28557344/transseptal-transcatheter-mitral-valve-in-valve-a-step-by-step-guide-from-preprocedural-planning-to-postprocedural-care
#7
Mayra Guerrero, Michael Salinger, Amit Pursnani, Paul Pearson, Mark Lampert, Justin Levisay, Hyde Russell, Ted Feldman
Transcatheter mitral valve replacement has been successfully performed with the use of aortic transcatheter heart valves in hundreds of patients worldwide with severe dysfunction of a degenerated mitral bioprosthesis and high surgical risk for repeat operation. The delivery approach in the vast majority of the mitral valve-in-valve procedures has been transapical. Although the transseptal approach may be more technically challenging, it is less invasive and may be preferred by patients. Data from case series and a large international registry suggest that patients treated with transseptal mitral valve-in-valve have faster recovery, more improvement in left ventricular ejection fraction and possibly lower mortality compared with patients treated with transapical approach...
May 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28544015/transfemoral-transcatheter-acurate-neo%C3%A2-aortic-valve-replacement-in-a-patient-with-a-previous-mechanical-mitral-valve
#8
Rodrigo Bagur, Vincenzo Pestrichella, Rosamaria Montesanti, Rossella Alemanni, Mauro Cassese
Transcatheter aortic valve replacement (TAVR) in the presence of a mechanical mitral valve (MMV) prosthesis is challenging due to the stiff mitral cage in the boundaries of the aorto-mitral curtain. We describe the technique for TAVR using the ACURATE-neo™ aortic bioprosthesis in a patient with a MMV prosthesis.
May 24, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28531333/the-flaws-in-the-detail-of-an-observational-study-on-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-intermediate-risks-patients
#9
Fabio Barili, Nick Freemantle, Thierry Folliguet, Claudio Muneretto, Michele De Bonis, Martin Czerny, Jean Francois Obadia, Nawwar Al-Attar, Nikolaos Bonaros, Jolanda Kluin, Roberto Lorusso, Prakash Punjabi, Rafael Sadaba, Piotr Suwalski, Umberto Benedetto, Andreas Böning, Volkmar Falk, Miguel Sousa-Uva, Pieter A Kappetein, Lorenzo Menicanti
The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28511922/simultaneous-transseptal-para-ring-leak-closure-and-transcatheter-mitral-valve-implantation-for-the-treatment-of-surgical-mitral-repair-failure
#10
James Roy, Mehdi Eskandari, Mark Monaghan, Olaf Wendler, Jonathan Byrne, Philip MacCarthy
Repeat cardiac surgery in patients with a previous sternotomy is associated with significant morbidity and mortality. While transcatheter aortic valve implantation in high risk surgical patients is now well established, experience with transcatheter mitral valve replacement is still at an early stage. Although many successful reports of transcatheter mitral valve replacements now exist, the predominant approach has been via a transapical approach. It is likely that, as with the evolution of favoured access routes for transcatheter aortic therapies, future directions for transcatheter mitral valves will focus on smaller delivery systems favouring the transvenous transseptal approach where possible...
April 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506938/dynamic-transcatheter-mitral-valve-repair-a-new-concept-to-treat-functional-mitral-regurgitation-using-an-adjustable-spacer
#11
Miriam Silaschi, Niki Nicou, Mehdi Eskandari, Omar Aldalati, Christopher Seguin, Thomas Piemonte, Theresa McDonagh, Rafal Dworakowski, Jonathan Byrne, Philip MacCarthy, Mark Monaghan, Olaf Wendler
We report about the first-in-man implantation of the Mitra-SpacerTM (Cardiosolutions Inc., West Bridgewater, MA/USA). It was implanted transapically. FMR was reduced to moderate degree. At two-months, while in NYHA II, LVEF had improved, but FMR increased and 2mL was added, reducing FMR to mild degree. Despite anticoagulation, thrombi developed around the device and the valve was replaced at eight-months. The Mitra-SpacerTM successfully bridged this patient to surgery after LVEF had recovered.
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28506459/increased-mitral-gradient-after-transcatheter-aortic-valve-replacement-is-it-anatomic-mitral-valve-obstruction-or-related-to-hemodynamics
#12
Michael Essandoh, Jonathan Tang, Leonid Gorelik
No abstract text is available yet for this article.
February 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28483264/transcatheter-aortic-valve-insertion-after-previous-mitral-valve-operation
#13
Kevin L Greason, Gurpreet S Sandhu, Vuyisile T Nkomo, Katherine S King, David L Joyce, Eric E Williamson, David R Holmes
OBJECTIVE: There are limited data on transcatheter aortic valve insertion after previous mitral valve operation. To better understand the associated procedural risks, we reviewed our single-center experience. METHODS: We retrospectively reviewed the records of 772 consecutive patients who received transcatheter aortic valve insertion from November 2008 through August 2016. There were 18 (2%) patients who had previous mitral valve operation that included valve repair in 4 patients (22%) and replacement in 14 (78%)...
April 4, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28473128/transcatheter-aortic-valve-implantation-within-degenerated-aortic-surgical-bioprostheses-partner-2-valve-in-valve-registry
#14
John G Webb, Michael J Mack, Jonathon M White, Danny Dvir, Philipp Blanke, Howard C Herrmann, Jonathon Leipsic, Susheel K Kodali, Raj Makkar, D Craig Miller, Philippe Pibarot, Augusto Pichard, Lowell F Satler, Lars Svensson, Maria C Alu, Rakesh M Suri, Martin B Leon
BACKGROUND: Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with acceptable acute procedural results. OBJECTIVES: The authors examined 30-day and 1-year outcomes in a large cohort of high-risk patients undergoing VIV TAVR. METHODS: Patients with symptomatic degeneration of surgical aortic bioprostheses at high risk (≥50% major morbidity or mortality) for reoperative surgery were prospectively enrolled in the multicenter PARTNER (Placement of Aortic Transcatheter Valves) 2 VIV trial and continued access registries...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28473116/elevated-mitral-valve-pressure-gradient-after-mitraclip-implantation-deteriorates-long-term-outcome-in-patients-with-severe-mitral-regurgitation-and-severe%C3%A2-heart-failure
#15
Michael Neuss, Thomas Schau, Akihiro Isotani, Markus Pilz, Maren Schöpp, Christian Butter
OBJECTIVES: This single-center study was performed to analyze the effect of an increased transvalvular gradient after the MitraClip (MC) (Abbott Laboratories, Abbott Park, Illinois) procedure on patient outcome during follow-up. BACKGROUND: Percutaneous transcatheter repair of the mitral valve with the MC device has been established as a novel technique for patients with severe mitral regurgitation and high surgical risk. This study investigated the influence of an increased pressure gradient after MC implantation on the long-term outcome of patients...
May 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28471059/long-or-redundant-leaflet-complicating-transcatheter-mitral-valve-replacement-case-vignettes-that-advocate-for-removal-or-reduction-of-the-anterior-mitral-leaflet
#16
Adam B Greenbaum, Jose F Condado, Marvin Eng, Stamatios Lerakis, Dee Dee Wang, Dennis W Kim, Robert J Lederman, Gaetano Paone, William W O Neill, Vinod H Thourani, Vasilis C Babaliaros
Transcatheter mitral valve replacement (TMVR) procedures can be an alternative to surgical valve replacement for high surgical risk patients with bioprosthetic mitral valves, annuloplasty rings, or severe mitral annular calcification (MAC). TMVR can trigger acute left ventricular outflow tract (LVOT) obstruction from permanent displacement of the native anterior mitral leaflet toward the left ventricular septum, more often among patients undergoing valve-in-ring and valve-in-MAC procedures. Although acute LVOT obstruction is well described in the literature, there are important additional complications of TMVR related to the length and/or redundancy of the anterior mitral valve that have been recognized after mitral valve surgery and have not been previously reported in the setting of TMVR...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28449780/transcatheter-mitral-valve-replacement-insights-from-early-clinical-experience-and%C3%A2-future%C3%A2-challenges
#17
REVIEW
Ander Regueiro, Juan F Granada, François Dagenais, Josep Rodés-Cabau
Transcatheter mitral valve repair, particularly edge-to-edge leaflet repair, is a well-established alternative for patients with severe primary mitral regurgitation (MR) considered at high or prohibitive surgical risk. More recently, transcatheter mitral valve replacement (TMVR) has emerged as a potential therapeutic option for the treatment of severe MR. TMVR may offer some advantages over transcatheter repair by providing a more complete and reproducible MR reduction. Several devices are under preclinical and clinical evaluation, and the early experience with more than 100 patients has demonstrated the feasibility of TMVR...
May 2, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28444201/mitral-periprosthetic-leakage-contemporary-results-of-surgical-correction-at-a-single-centre%C3%A2
#18
Luca Botta, Benedetta De Chiara, Salvina Quattrocchi, Francesca Casadei, Francesco Borgia, Cristina Giannattasio, Antonella Moreo, Claudio Francesco Russo
OBJECTIVES: Mitral periprosthetic leakage (PPL) is a serious complication following valve replacement. Conflicting outcomes of surgical treatment have been reported in the presence of multiple previous cardiac operations and associated co-pathological conditions. METHODS: Sixty-five symptomatic patients (37 women, mean age 64.8 years) underwent conventional operations at our hospital from 2006 to 2015. Mitral PPL was the leading surgical indication, although associated procedures were included...
April 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28441151/recent-clinical-trials-in-valvular-heart-disease
#19
Daniel Kiss, Saif Anwaruddin
PURPOSE OF REVIEW: With widespread adoption of transcatheter aortic valve replacement, there has been a change in the approach to management of valvular heart disease. New interest has taken hold in transcatheter therapies for valvular heart disease, as well as research into pathophysiology and progression of disease. Additionally, several key trials have further refined our understanding of surgical management of valvular heart disease. This review will elucidate recent clinical trial data leading to changes in practice...
July 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28427597/intentional-percutaneous-laceration-of%C3%A2-the%C3%A2-anterior-mitral-leaflet-to-prevent%C3%A2-outflow%C3%A2-obstruction-during-transcatheter-mitral-valve-replacement-first-in-human%C3%A2-experience
#20
Vasilis C Babaliaros, Adam B Greenbaum, Jaffar M Khan, Toby Rogers, Dee Dee Wang, Marvin H Eng, William W O'Neill, Gaetano Paone, Vinod H Thourani, Stamatios Lerakis, Dennis W Kim, Marcus Y Chen, Robert J Lederman
OBJECTIVES: This study sought to use a new catheter technique to split the anterior mitral valve leaflet (AML) and prevent iatrogenic left ventricular outflow tract (LVOT) obstruction immediately before transcatheter mitral valve replacement (TMVR). BACKGROUND: LVOT obstruction is a life-threatening complication of TMVR, caused by septal displacement of the AML. METHODS: The procedure was used in patients with severe mitral valve disease and prohibitive surgical risk...
April 24, 2017: JACC. Cardiovascular Interventions
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