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Tommaso CL, Fullerton DA, Feldman T, Dean LS, Hijazi ZM, Horlick E, Weiner BH, Zahn E, Cigarroa JE, Ruiz CE, Bavaria J, Mack MJ, Cameron DE, Bolman RM, Craig Miller D, Moon MR, Mukherjee D, Trento A, Aldea GS, Bacha EA. SCAI/AATS/ACC/STS operator and institutional requirements for transcatheter valve repair and replacement. Part II. Mitral valve. Catheter Cardiovasc Interv 2014; 84:567-80. [PMID: 24828236 DOI: 10.1002/ccd.25540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 05/06/2014] [Indexed: 01/22/2023]
Affiliation(s)
- Carl L Tommaso
- Cardiac Cath Lab, North Shore Cardiologists, North Shore University Health System, 9669 North Kenton, Skokie, Illinois
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Functional Mitral Regurgitation: Therapeutic Strategies for a Ventricular Disease. J Card Fail 2014; 20:252-67. [DOI: 10.1016/j.cardfail.2014.01.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 01/02/2014] [Accepted: 01/10/2014] [Indexed: 12/25/2022]
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A look at recent improvements in the durability of tissue valves. Gen Thorac Cardiovasc Surg 2013; 61:182-90. [DOI: 10.1007/s11748-013-0202-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Indexed: 10/27/2022]
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Tommaso CL, Bolman RM, Feldman T, Bavaria J, Acker MA, Aldea G, Cameron DE, Dean LS, Fullerton D, Hijazi ZM, Horlick E, Miller DC, Moon MR, Ringel R, Ruiz CE, Trento A, Weiner BH, Zahn EM. Multisociety (AATS, ACCF, SCAI, and STS) Expert Consensus Statement: Operator and Institutional Requirements for Transcatheter Valve Repair and Replacement, Part 1: Transcatheter Aortic Valve Replacement. Ann Thorac Surg 2012; 93:2093-110. [DOI: 10.1016/j.athoracsur.2012.02.063] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 02/24/2012] [Accepted: 02/24/2012] [Indexed: 01/22/2023]
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Feldman T, Ruiz CE, Hijazi ZM. The SCAI Structural Heart Disease Council: Toward addressing training, credentialing, and guidelines for structural heart disease intervention. Catheter Cardiovasc Interv 2010; 76:E87-9. [DOI: 10.1002/ccd.22701] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ussia GP, Scarabelli M, Mulè M, Barbanti M, Cammalleri V, Immè S, Aruta P, Pistritto AM, Carbonaro A, Deste W, Sciuto P, Licciardello G, Calvi V, Tamburino C. Postprocedural management of patients after transcatheter aortic valve implantation procedure with self-expanding bioprosthesis. Catheter Cardiovasc Interv 2010; 76:757-66. [DOI: 10.1002/ccd.22602] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Thomas M, Wendler O. Transcatheter aortic valve implantation (TAVI): how to interpret the data and what data is required? EUROINTERVENTION 2009; 5:25-7. [DOI: 10.4244/eijv5i1a4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Vahanian A, Alfieri O, Al-Attar N, Antunes M, Bax J, Cormier B, Cribier A, De Jaegere P, Fournial G, Kappetein A, Kovac J, Ludgate S, Maisano F, Moat N, Mohr F, Nataf P, Pierard L, Pomar J, Schofer J, Tornos P, Tuzcu M, van Hout B, Von Segesser L, Walther T. Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). EUROINTERVENTION 2008; 4:193-9. [DOI: 10.4244/eijv4i2a36] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur J Cardiothorac Surg 2008; 34:1-8. [PMID: 18502659 DOI: 10.1016/j.ejcts.2008.04.039] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Revised: 04/03/2008] [Accepted: 04/15/2008] [Indexed: 12/18/2022] Open
Abstract
AIMS To critically review the available transcatheter aortic valve implantation techniques and their results, as well as propose recommendations for their use and development. METHODS AND RESULTS A committee of experts including European Association of Cardio-Thoracic Surgery and European Society of Cardiology representatives met to reach a consensus based on the analysis of the available data obtained with transcatheter aortic valve implantation and their own experience. The evidence suggests that this technique is feasible and provides haemodynamic and clinical improvement for up to 2 years in patients with severe symptomatic aortic stenosis at high risk or with contraindications for surgery. Questions remain mainly concerning safety and long-term durability, which have to be assessed. Surgeons and cardiologists working as a team should select candidates, perform the procedure, and assess the results. Today, the use of this technique should be restricted to high-risk patients or those with contraindications for surgery. However, this may be extended to lower risk patients if the initial promise holds to be true after careful evaluation. CONCLUSION Transcatheter aortic valve implantation is a promising technique, which may offer an alternative to conventional surgery for high-risk patients with aortic stenosis. Today, careful evaluation is needed to avoid the risk of uncontrolled diffusion.
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Alfieri O, De Bonis M, Maisano F, La Canna G. Future Directions in Degenerative Mitral Valve Repair. Semin Thorac Cardiovasc Surg 2007; 19:127-32. [PMID: 17870007 DOI: 10.1053/j.semtcvs.2007.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2007] [Indexed: 11/11/2022]
Abstract
Mitral valve repair is by far the most common operation for degenerative mitral regurgitation. If the procedure is performed before left ventricular dysfunction occurs and atrial fibrillation develops, the operative risk is very low and life expectancy is super imposable to that of the sex- and age-matched population. Despite these achievements, there are areas that could still be improved. Progress in treating degenerative mitral regurgitation is expected to move along several directions. More precise diagnostic methods will be developed to reliably quantify mitral regurgitation and identify early irreversible ventricular and atrial changes. The refinement of surgical techniques and search for new, innovative solutions should never be abandoned. Finally, transcatheter correction of mitral regurgitation represents a new, emerging field of cardiovascular medicine and is expected to have a significant impact on the surgical practice in the future.
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Affiliation(s)
- Ottavio Alfieri
- Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy.
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McVeigh ER, Guttman MA, Lederman RJ, Li M, Kocaturk O, Hunt T, Kozlov S, Horvath KA. Real-time interactive MRI-guided cardiac surgery: aortic valve replacement using a direct apical approach. Magn Reson Med 2007; 56:958-64. [PMID: 17036300 PMCID: PMC1963465 DOI: 10.1002/mrm.21044] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Minimally invasive cardiac surgery requires arresting and emptying of the heart, which compromises visualization of the surgical field. In this feasibility study a novel surgical procedure is demonstrated in which real-time MRI is used to guide the placement of a prosthetic aortic valve in the beating heart via direct apical access in eight porcine hearts. A clinical stentless bioprosthetic valve affixed to a platinum stent was compressed onto a balloon-tipped catheter. This was fed through a 15-18-mm delivery port inserted into the left ventricular (LV) apex via a minimally invasive subxyphoid incision. Using interactive real-time MRI, the surgeon implanted the prosthetic valve in the correct location at the aortic annulus within 90 s. In four of the animals immediately after implantation, ventricular function, blood flow through the valve, and myocardial perfusion were evaluated with MRI. MRI-guided beating-heart surgery may provide patients with a less morbid and more durable solution to structural heart disease.
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Affiliation(s)
- Elliot R McVeigh
- Laboratory of Cardiac Energetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892-1061, USA.
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Antunes MJ. Off-pump aortic valve replacement with catheter-mounted valved stents. Is the future already here? Eur J Cardiothorac Surg 2007; 31:1-3. [PMID: 17070064 DOI: 10.1016/j.ejcts.2006.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2006] [Revised: 10/02/2006] [Accepted: 10/03/2006] [Indexed: 10/24/2022] Open
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Joudinaud TM, Flecher EM, Curry JW, Kegel CL, Weber PA, Duran CMG. Sutureless Stented Aortic Valve Implantation Under Direct Vision: Lessons From a Negative Experience in Sheep. J Card Surg 2007; 22:13-7. [PMID: 17239204 DOI: 10.1111/j.1540-8191.2007.00337.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM OF THE STUDY Percutaneous aortic valve replacement has been proposed as a valid alternative to surgery in selected cases; however, it still has many problems. As a less radical preliminary step, we implanted a balloon-expandable stented aortic valve under direct vision in sheep. METHODS Under cardiopulmonary bypass (CPB) and through a transverse aortotomy, an aortic valve mounted in a long tubular balloon-expandable stent was implanted in six acute sheep. The leaflets were not excised and no anchoring sutures were used between stent and native annulus. Epicardial, two-dimensional color Doppler echocardiography was used to assess the function of the stented valve followed by macroscopic inspection at necropsy. RESULTS Direct visualization of the entire annulus when the collapsed, valved stent was placed within the aortic root was difficult in all animals. Valve deployment took less than 1 minute. The surgical procedure resulted in major complications in all cases. Migration (3/6), paravalvular leak (2/6), mitral conflicts resulting in mitral regurgitation (1/6), and coronary ostia obstruction (2/6) were the major events at the origin of the failure. Only three animals could be weaned from CPB but did not recover enough to survive the procedure. CONCLUSIONS Sutureless implantation of a stented aortic valve through standard CPB and aortotomy is far more complex than expected. Changes in stent design and surgical approach are indicated.
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Affiliation(s)
- Thomas M Joudinaud
- The International Heart Institute of Montana Foundation at Saint Patrick Hospital and Health Sciences Center and The University of Montana, Missoula, Montana 59802, USA
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Flecher EM, Joudinaud TM, Duran CMG. [Percutaneous cardiac valve replacement: a review]. Ann Cardiol Angeiol (Paris) 2006; 55:144-8. [PMID: 16792030 DOI: 10.1016/j.ancard.2005.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Surgery is no longer the only technique to replace a cardiac valve. New percutaneous procedures allow aortic or pulmonary valve implantation. Even if the feasibility of these procedures has been proved, cases reported are very rare and selected. This emergent technology is still at an early stage of development and new prospective studies will be necessary to evaluate these procedures correctly before concluding their clinical benefit. At this time surgery remains the gold standard in terms of cardiac valve replacement.
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Affiliation(s)
- E M Flecher
- International Heart Institute of Montana Foundation at Saint Patrick Hospital and Health Science Center, The University of Montana, 554, West Broadway, Missoula, Montana 59802, USA.
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Gillinov AM, Cosgrove DM. Reply. Ann Thorac Surg 2006. [DOI: 10.1016/j.athoracsur.2005.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Babaliaros V, Cribier A, Agatiello C. Surgery Insight: current advances in percutaneous heart valve replacement and repair. ACTA ACUST UNITED AC 2006; 3:256-64. [PMID: 16645666 DOI: 10.1038/ncpcardio0534] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Accepted: 02/16/2006] [Indexed: 11/09/2022]
Abstract
Several advances have been made in interventional cardiology, particularly in the field of valvular heart disease. Among the procedures for which technologies are available, percutaneous replacement of the pulmonary and aortic valves, and percutaneous repair of the mitral valve, via annuloplasty or the Alfieri method, are the best known. Along with the excitement generated by these new subspecialties, however, there has also been skepticism. In this article we focus on the current innovations that have been applied to the procedures in humans, and discuss the advantages and disadvantages of the different strategies.
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