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Transcatheter mitral valve repair

Richard Cheng, Emily Tat, Robert J Siegel, Reza Arsanjani, Asma Hussaini, Moody Makar, Yukiko Mizutani, Alfredo Trento, Saibal Kar
AIMS: Mitral annular calcification (MAC) negatively influences outcomes in surgical mitral valve (MV) repair for mitral regurgitation (MR). However, there are no data on whether MAC impacts on outcomes of MitraClip percutaneous MV edge-to-edge repair. This study sought to investigate whether the presence of MAC impacts on the procedural success and durability of percutaneous transcatheter repair of MR using the MitraClip. METHODS AND RESULTS: One hundred and seventy-three patients undergoing MitraClip repair for significant MR were studied...
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
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
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
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
Carmelo Grasso
No abstract text is available yet for this article.
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
Frank Van Praet, Apostolos Roubelakis, José Coddens, Filip Casselman
This report describes an approach for the treatment of high-risk native mitral valve stenosis. It incorporates the deployment of a transcatheter valve in the mitral position under full endoscopic vision, combined with endoscopic mitral repair techniques that secure valve positioning and reduce the risk of paravalvular leak. This approach could be used as a rescue procedure in centres with experience in transcatheter and endoscopic valve techniques.
September 5, 2016: Interactive Cardiovascular and Thoracic Surgery
Riccardo Vismara, Guido Gelpi, Santosh Prabhu, Paolo Romitelli, Lauren G Troxler, Andrea Mangini, Claudia Romagnoni, Monica Contino, Dylan T Van Hoven, Federico Lucherini, Michal Jaworek, Alberto Redaelli, Gianfranco B Fiore, Carlo Antona
BACKGROUND: Although associated with left heart pathologies, functional tricuspid regurgitation (FTR) is often left untreated during left heart surgery. Hence, owing to its degenerative character, reoperation is often needed, encompassing an impressive (25% to 35%) mortality rate. Thus transcatheter approaches to FTR are raising great interest. OBJECTIVES: The authors evaluated the post-treatment effectiveness of the edge-to-edge technique using the percutaneous mitral valve repair device in an ex vivo pulsatile model of FTR...
September 6, 2016: Journal of the American College of Cardiology
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
Kyle Eudailey, Nadira Hamid, Rebecca T Hahn, Susheel Kodali, William Gray, Isaac George
With the advent of percutaneous valve interventions, the landscape for management of high-risk valve replacement and repair has changed dramatically. Transcatheter valve repair/replacement techniques can be used in conjunction with open surgery to facilitate a hybrid approach in patients with multivalve disease. We present a case of staged hybrid valve repair followed by surgical replacement for a high-risk patient with mitral regurgitation and aortic regurgitation. This case illustrates the effectiveness of the staged hybrid approach for high-risk patients with incomplete transcatheter options...
August 2016: Annals of Thoracic Surgery
Konstantinos Dean Boudoulas, Antonios A Pitsis, Harisios Boudoulas
Mitral valve prolapse (MVP) results from the systolic movement of a portion(s) or segment(s) of the mitral valve leaflet(s) into the left atrium during left ventricular (LV) systole. It should be emphasised that MVP alone, as defined by imaging techniques, may comprise a non-specific finding because it also depends on the LV volume, myocardial contractility and other LV hemodynamics. Thus, a floppy mitral valve (FMV) should be the basis for the diagnosis of MVP. Two types of symptoms may be defined in these patients...
March 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Panagiotis Antiochos, Olivier Muller, Matthias Kirsch, Melissa Agostini, Salah Qanadli, Eric Eeckhout, Pierre Vogt, René Prêtre, Alain Delabays, Xavier Jeanrenaud, Pierre Monney
Mitral regurgitation (MR) is the most frequent valvular disease in industrialised countries. MR is classified as primary (mostly degenerative with valve prolapse) or secondary (mainly due to underlying ischemic heart disease resulting in deformation of the valve structure). Surgical repair represents the optimal treatment for severe primary MR, whereas the benefits of surgical correction of secondary MR are controversial. Over the past few years, transcatheter techniques have been developed to treat MR, such as the percutaneous edge-to-edge procedure (MitraClip)...
May 25, 2016: Revue Médicale Suisse
Joseph L Blackshear, Chad W McRee, Robert E Safford, Peter M Pollak, Mark E Stark, Colleen S Thomas, Candido E Rivera, Ewa M Wysokinska, Dong Chen
IMPORTANCE: Limited data suggest that von Willebrand factor (VWF) abnormalities may accompany the high-shear state associated with prosthetic valve dysfunction. If true, laboratory testing could add value in quantifying prosthesis dysfunction and could suggest a pathophysiological explanation for acquired bleeding in some patients. OBJECTIVES: To determine whether dysfunctional valve prostheses are associated with VWF abnormalities compared with normally functioning valve prostheses, to identify the severity of the VWF abnormality relative to other conditions, and to describe associated bleeding and the occurrence of gastrointestinal angiodysplasia...
May 1, 2016: JAMA Cardiology
Rebecca T Hahn
Transcatheter aortic valve replacement for treatment of aortic stenosis has now become an accepted alternative to surgical valve replacement for some patients. In addition, transcatheter mitral valve repair is also routinely used in high surgical risk patients with mitral regurgitation. Other transcatheter procedures are in rapid development. The current review attempts to summarize the procedures and echocardiographic imaging used for transcatheter valve replacement or valve repair.
July 8, 2016: Circulation Research
Julia Wallenborn, Sebastian Herrmann, Marc Hansen, Kai Hu, Wolfram Voelker, Stefan Störk, Georg Ertl, Frank Weidemann
In patients with relevant mitral regurgitation (MR), transcatheter edge-to-edge repair (also called MitraClip) provides an alternative treatment option especially for inoperable or high-risk patients. In preparation for the procedure, echocardiography is the method of choice for assessment of mitral valve (MV) morphology and function and thus provides important information if successful treatment of MR can be accomplished by MitraClip. This review article provides structured and detailed guidance how to systematically assess functional and degenerative MR and MV pathology by echocardiography in order to select eligible patients for this procedure...
July 2016: Echocardiography
Mikihiko Kudo, Hideyuki Shimizu
Minimally invasive cardiac surgery (MICS), first introduced in the 1990s, was originally performed via partial sternotomy, the subxyphoid approach, and right anterolateral thoracotomy. Over the past 20 years, MICS procedures have progressed from mere alternatives to standard full sternotomy to endoscope-assisted and then to totally endoscopic open-heart procedures. MICS has gained popularity among surgeons and patients; without sacrificing the safety level and durability of cardiac procedures equivalent to median sternotomy, refinement of MICS technologies has resulted in a decrease in length of hospital stay, less postoperative pain, faster patient recovery, and faster return to activities of normal daily living...
March 2016: Nihon Geka Gakkai Zasshi
Maurizio Taramasso, Devdas T Inderbitzin, Andrea Guidotti, Fabian Nietlispach, Oliver Gaemperli, Michel Zuber, Francesco Maisano
Direct mitral valve annuloplasty is a transcatheter mitral valve repair approach that mimics the conventional surgical approach to treat functional mitral regurgitation. The Cardioband system (Valtech Cardio, Inc., Or-Yehuda, Israel) is delivered by a trans-septal approach and the implant is performed on the atrial side of the mitral annulus, under live echo and fluoroscopic guidance using multiple anchor elements. The Cardioband system obtained CE mark approval in October 2015, and initial clinical experiences are promising with regard to feasibility, safety and efficacy...
2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Wen Zhang, Renjie Hu, Lei Zhang, Hongbin Zhu, Haibo Zhang
OBJECTIVE: Isolated congenital coronary artery fistula is a rare condition, and the surgical experience for treating this condition is limited. METHODS: This was a retrospective review of 47 patients who underwent surgical repair of isolated congenital coronary artery fistula from January 2001 to March 2015. RESULTS: All but 1 patient presented with no symptoms. The median age at operation was 3.9 years (range, 0.4-15.2 years), and the median weight was 15...
October 2016: Journal of Thoracic and Cardiovascular Surgery
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