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Transcatheter mitral valve repair

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https://www.readbyqxmd.com/read/29897014/future-technology-of-mitral-valve-repair-and-replacement-for-mitral-valve-disease
#1
Kelly Kohorst, Mias Pretorius
Mitral regurgitation is the most common valvular disease and significant (moderate/severe) mitral regurgitation is found in 2.3% of the population older than 65 years. New transcatheter minimally invasive technologies are being developed to address mitral valve disease in patients deemed too high a risk for conventional open-heart surgery. There are several features of the mitral valve (saddle-shaped noncalcified annulus with irregular leaflet geometry) that make a transcatheter approach to repair or replacing the valve more challenging compared with the aortic valve...
June 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29897008/interventional-echocardiography-of-the-mitral-valve-what-the-interventionist-wants-to-know
#2
Ludmil Mitrev, Nayan Desai, Ahmed Awad, Sajjad Sabir
The past 2 decades have seen a proliferation of transcatheter mitral valve (MV) therapies, which are less invasive and distinct from surgical MV repair or replacement. The commonly used MV transcatheter therapies include (1) percutaneous mitral balloon commissurotomy (PMBC) for rheumatic mitral stenosis; (2) edge-to-edge repair with the MitraClip for mitral regurgitation; (3) valve-in-valve implantation in bioprosthetic MV, native MV, or mitral ring; and (4) closure of paravalvular leaks (PVLs). This article will focus on the use of echocardiography in the diagnosis, patient selection, procedural guidance, and postprocedural follow-up for PMBC, with notes on the role of transesophageal echocardiography in transcatheter interventions for prosthetic valve degeneration and PVL closure...
June 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29880112/imaging-for-mitral-interventions-methods-and-efficacy
#3
REVIEW
Nina C Wunderlich, Roy Beigel, Siew Y Ho, Fabian Nietlispach, Richard Cheng, Eustachio Agricola, Robert J Siegel
The mitral valve (MV) is a complex and intricate structure. With the development of transesophageal echocardiography in the 1990s, it became possible to evaluate MV anatomy and function in real time during surgical procedures. Subsequently, new surgical and percutaneous techniques for MV repair as well as replacement have evolved. Development of 3-dimensional and intracardiac echocardiography, as well as computed tomography, cardiac resonance imaging, and most recently fusion imaging, have paved the way for a more comprehensive evaluation of the MV as well as for the planning of percutaneous MV procedures such as balloon valvuloplasty, paravalvular mitral leak closure, percutaneous edge-to-edge repair, transcatheter MV annuloplasty, artificial chord implantation, and transcatheter MV replacement...
June 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29868864/transapical-valve-in-ring-mitral-valve-implantation-through-the-anterior-mitral-valve-leaflet
#4
Luke J Rogers, Ian Cox, Malcolm Dalrymple-Hay, Clinton Lloyd
Transcatheter mitral valve implantation is a relatively novel intervention that replaces the mitral valve of individuals deemed too high-risk or unsuitable for surgery. It is associated with a number of specific risks, including left ventricular outflow tract obstruction. In this report, we present the case of a 75-year-old man who was unable to undergo redo surgical repair and had a number of risk factors for left ventricular outflow tract obstruction. To minimize this risk, we deployed transcatheter mitral valve implantation within the anterior mitral valve leaflet resulting in mild mitral valve regurgitation postoperatively and no left ventricular outflow tract obstruction...
June 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29791711/percutaneous-edge-to-edge-transcatheter-mitral-valve-repair-current-indications-and-future-perspectives
#5
Martino Pepe, Emanuela De Cillis, Tommaso Acquaviva, Annagrazia Cecere, Pasquale D'Alessandro, Arturo Giordano, Marco Matteo Ciccone, Alessandro Santo Bortone
Mitral regurgitation (MR) is the most prevalent valvular heart disease (VHD) and represents an important cause of heart failure. Medical therapy has a limited role in improving symptoms and does not hinder the progression of valvular disease. Surgery is the treatment of choice for severe symptomatic MR; valve repair is currently the preferred surgical approach because it reduces peri-operative mortality and ensures a good medium- to long-term survival outcome. Nevertheless, a non-negligible proportion of patients with indications for surgical correction are considered to be at prohibitive perioperative risk, mainly because of old age and multiple comorbidities...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#6
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29770888/mitral-valve-interventions-in-structural-heart-disease
#7
REVIEW
Matteo Saccocci, Maurizio Taramasso, Francesco Maisano
PURPOSE OF REVIEW: Analyze the current state of the art and the future perspectives of mitral interventions in clinical setting. RECENT FINDINGS: A systematic and critical review of the new mitral percutaneous therapies and imaging technologies is the basis to adopt the right treatment for each patient according to specific valve dysfunction and clinical presentation, waiting for definitive guidelines. While surgical mitral repair will remain the gold standard for low-risk healthy patients with degenerative mitral regurgitation (DMR), transcatheter mitral valve repair is becoming first line therapy in high risk patients with functional mitral regurgitation (FMR)...
May 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29762933/ross-procedure-following-a-dislodged-transcatheter-aortic-valve-replacement
#8
Samuel R Schnittman, Aaron J Weiss, Robin Varghese, Paul Stelzer
A 36-year-old pregnant woman with a history of rheumatic heart disease and prior aortic valve replacement and mitral valve repair presented to an outside hospital with severe aortic stenosis. The patient had a cardiac arrest upon labor induction and underwent a transcatheter aortic valve replacement (TAVR), which dislodged two days later. Five months later, the patient underwent removal of the dislodged TAVR and a Ross procedure at the authors' institution. The patient was stable upon discharge, with minimal aortic and pulmonary regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29759741/outcomes-of-repeat-mitral-valve-replacement-in-patients-with-prior-mitral-surgery-a-benchmark-for-transcatheter-approaches
#9
Julius I Ejiofor, Sameer A Hirji, Fernando Ramirez-Del Val, Anthony V Norman, Siobhan McGurk, Sary F Aranki, Prem S Shekar, Tsuyoshi Kaneko
OBJECTIVES: With the emergence of transcatheter mitral valve-in-valve/ring replacement for deteriorated bioprostheses or failed repair, comparative clinical benchmarks for surgical repeat mitral valve replacement (re-MVR) are needed. We present in-hospital and survival outcomes of a 24-year experience with re-MVR. METHODS: From January 1992 to June 2015, 520 adult patients underwent re-MVR; 273 had undergone prior mitral valve repair (pMVP) and 247 had undergone prior MVR (pMVR)...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29745455/infective-endocarditis-following-transcatheter-edge-to-edge-mitral-valve-repair-a-systematic-review
#10
Lluis Asmarats, Tania Rodriguez-Gabella, Chekrallah Chamandi, Mathieu Bernier, Jonathan Beaudoin, Kim O'Connor, Eric Dumont, François Dagenais, Jean-Michel Paradis, Josep Rodés-Cabau
OBJECTIVES: To assess the clinical characteristics, management, and outcomes of patients diagnosed with infective endocarditis (IE) after edge-to-edge mitral valve repair with the MitraClip device. BACKGROUND: Transcatheter edge-to-edge mitral valve repair has emerged as an alternative to surgery in high-risk patients. However, few data exist on IE following transcatheter mitral procedures. METHODS: Four electronic databases (PubMed, Google Scholar, Embase, and Cochrane Library) were searched for original published studies on IE after edge-to-edge transcatheter mitral valve repair from 2003 to 2017...
May 10, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29743999/transcatheter-mitral-valve-replacement-for-native-and-failed-bioprosthetic-mitral-valves
#11
REVIEW
Kunal Sarkar, Michael J Reardon, Stephen H Little, Colin M Barker, Neal S Kleiman
Transcatheter mitral valve replacement (TMVR) is a novel approach for treatment of severe mitral regurgitation. A number of TMVR devices are currently undergoing feasibility trials using both transseptal and transapical routes for device delivery. Overall experience worldwide is limited to fewer than 200 cases. At present, the 30-day mortality exceeds 30% and is attributable to both patient- and device-related factors. TMVR has been successfully used to treat patients with degenerative mitral stenosis (DMS) as well as failed mitral bioprosthesis and mitral repair using transcatheter mitral valve-in-valve (TMViV)/valve-in-ring (ViR) repair...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743996/emerging-transcatheter-options-for-tricuspid-regurgitation
#12
REVIEW
Ankur Kalra, Angad S Uberoi, Azeem Latib, Sahil Khera, Stephen H Little, Deepak L Bhatt, Michael J Reardon, Neal S Kleiman, Colin M Barker
Tricuspid regurgitation (TR) presents as either primary valve pathology or secondary to pulmonary or left-sided heart disease. Severe TR portends a worse prognosis independent of age, right ventricular size and function, severe left ventricular dysfunction, and increased pulmonary arterial pressures. Surgical treatment for TR has mostly been limited to patients undergoing mitral valve repair since those at high surgical risk are not candidates for traditional TR surgery. For these patients, minimally invasive techniques could be of great benefit, yet these techniques have been slow to develop because of the various anatomic and physiological aspects of the tricuspid valve apparatus...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743995/percutaneous-repair-of-mitral-regurgitation
#13
REVIEW
Colin M Barker
Mitral regurgitation (MR) affects more than 2 million people in the United States annually and is the second leading cause of heart valve disease after aortic stenosis. Surgical intervention is the currently accepted treatment of choice in patients with either symptomatic degenerative MR or asymptomatic MR with pulmonary hypertension, atrial fibrillation, or left ventricular dysfunction. Based on robust evidence from clinical trials, the MitraClip Transcatheter Mitral Valve Repair system (Abbott Vascular) was approved in the United States for commercial use in 2013...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29741485/one-year-results-of-transcatheter-treatment-of-severe-tricuspid-regurgitation-using-the-edge-to-edge-repair-technique
#14
Daniel Braun, Michael Nabauer, Mathias Orban, Andrea Englmaier, Diana Rösler, Christian Hagl, Steffen Massberg, Jörg Hausleiter
AIMS: The aim of this study was to evaluate one-year durability and clinical outcome of transcatheter tricuspid valve repair using the edge-to-edge repair technique in symptomatic patients with severe tricuspid regurgitation (TR). METHODS AND RESULTS: We evaluated twenty-four consecutive patients suffering from severe right sided heart failure (NYHA III-IV) primarily due to moderate to severe primary tricuspid regurgitation. Applying a modified steering technique for clip delivery, 8 patients were treated for isolated severe TR, while 16 patients were treated for moderate to severe TR and concomitant severe mitral regurgitation...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29718146/echocardiographic-fluoroscopic-fusion-imaging-for-transcatheter-mitral-valve-repair-guidance
#15
Francesco F Faletra, Alberto Pozzoli, Eustachio Agricola, Andrea Guidotti, Luigi Biasco, Laura Anna Leo, Maurizio Taramasso, Elena Pasotti, Shingo Kuwata, Marco Moccetti, Felix C Tanner, Giovanni Pedrazzini, Fabian Nietlispach, Tiziano Moccetti, Michel Zuber, Francesco Maisano
The echocardiographic-fluoroscopic fusion imaging is a new imaging system which has recently become available, with the proposal to facilitate catheters and device navigation during catheter-based structural heart disease interventions. Several reports have described the early developments and the first clinical experiences, but literature focusing on the practical applications of fusion imaging technology to mitral valve transcatheter interventions, and on its potential advantages and current limitations, is still limited...
April 27, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29697545/transcatheter-valvular-interventions-in-2017-some-things-old-some-things-new
#16
Hasan Rehman, Neal S Kleiman, Ankur Kalra
PURPOSE OF REVIEW: Transcatheter valvular interventions have changed the landscape of valvular therapies. We examine some studies on transcatheter valvular interventions published in the year 2017 to better understand their implications on clinical practice and future research. RECENT FINDINGS: Findings from the SURTAVI study suggest TAVR to be a reasonable option in intermediate risk patients with aortic stenosis. Recent studies indicate that valve leaflet thrombosis is associated with poor outcomes...
July 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29678512/galectin-3-is-associated-with-left-ventricular-reverse-remodeling-and-outcome-after-percutaneous-mitral-valve-repair
#17
Christine S Zuern, Niklas Floss, Iris I Mueller, Christian Eick, Martin Duckheim, Johannes Patzelt, Meinrad Gawaz, Andreas E May, Karin A L Mueller
BACKGROUND: Plasma Galectin-3 is a marker of myocardial inflammation and fibrosis, was associated with left ventricular (LV) reverse remodeling after conventional surgical mitral valve repair (MVR) and predicted clinical events in patients undergoing transcatheter aortic valve replacement (TAVR). We aimed to evaluate the association between pre-interventional Galectin-3 levels and (1) reverse LV remodeling and (2) major adverse cardiovascular events (MACE) in patients undergoing percutaneous MVR...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29676043/mitral-valve-interventions-in-heart-failure
#18
REVIEW
Daniel Lavall, Andreas Hagendorff, Stephan H Schirmer, Michael Böhm, Michael A Borger, Ulrich Laufs
Secondary mitral regurgitation (MR) results from left ventricular dilatation and dysfunction. Quantification of secondary MR is challenging because of the underlying myocardial disease. Clinical and echocardiographic evaluation requires a multi-parametric approach. Severe secondary MR occurs in up to one-fourth of patients with heart failure with reduced ejection fraction, which is associated with a mortality rate of 40% to 50% in 3 years. Percutaneous edge-to-edge mitral valve repair (MitraClip) has emerged as an alternative to surgical valve repair to improve symptoms, functional capacity, heart failure hospitalizations, and cardiac haemodynamics...
April 19, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29656614/6-minute-walk-test-predicts-prolonged-hospitalization-in-patients-undergoing-transcatheter-mitral-valve-repair-by-mitraclip
#19
Mike Saji, Marc R Katz, Gorav Ailawadi, Timothy S Welch, Dale E Fowler, Jamie L W Kennedy, James D Bergin, Ivandito Kuntjoro, John M Dent, Michael Ragosta, D Scott Lim
BACKGROUND: The 6-minute walk test (6MWT) is a simple functional test that can predict exercise capacity and is widely employed to assess treatment outcomes. Although mortality with transcatheter mitral valve repair (TMVr) using the MitraClip (Abbott Vascular, Menlo Park, CA) is significantly less than for open mitral valve surgery in high-risk patients, identifying which patient will benefit the most from TMVr remains a concern. There are limited prognostic metrics guiding patient selection and, no studies have reported relationship between prolonged hospitalization and 6MWT...
April 15, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29625648/role-of-echocardiography-in-transcatheter-mitral-valve-replacement-in-native-mitral-valves-and-mitral-rings
#20
REVIEW
G Burkhard Mackensen, James C Lee, Dee Dee Wang, Paul J Pearson, Philipp Blanke, Danny Dvir, James N Kirkpatrick
Adaptation and evolution of transcatheter aortic valve replacement (TAVR) technologies has led to approval of TAVR for consideration in patients at intermediate risk for surgical aortic valve intervention. As TAVR becomes more mainstream, attention is shifting toward percutaneous mitral valve (MV) repair and transcatheter MV replacement (TMVR) techniques. Transcatheter heart valves (both purpose-built and off-label-use TAVR valves) are being implanted during TMVR procedures to treat clinically significant MV disease (native disease, degenerated bioprosthetic valves, and dysfunctional surgical MV annuloplasty repairs) when the risk of open heart MV surgery is prohibitive...
April 2018: Journal of the American Society of Echocardiography
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