1
|
Beyer M, Muller D, De Marco F, Badhwar V, Obadia JF, Praz F, Modine T, Tonino P, Dahle G, Cerillo A, Ludwig S, Conradi L. Secondary retensioning of a tether-based device for transapical transcatheter mitral valve implantation. Eur J Cardiothorac Surg 2024; 65:ezad430. [PMID: 38152923 DOI: 10.1093/ejcts/ezad430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/14/2023] [Accepted: 12/27/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES Relevant paravalvular leakage (PVL) due to prosthesis dislodgement is a rare but potentially severe complication after transcatheter mitral valve implantation (TMVI). Due to the epicardial anchoring mechanism of the Tendyne® TMVI system, repositioning of the valve stent may be possible by retensioning of the tether. This multicentre study aimed to investigate the procedural and short-term safety as well as efficacy of retensioning manoeuvres. METHODS From 2017 to 2021, N = 18 patients who underwent secondary tether retensioning were identified. Baseline, procedural and follow-up data were available from N = 11 patients and analysed according to the Mitral Valve Research Consortium definitions. Continuous variables are shown as median with interquartile range. RESULTS All patients [age 75 years (73.5, 85.0), 64% male (N = 7), EuroSCORE II 6.2% (5.8, 11.6)] presented with post-procedural PVL [63.6% (N = 7) with PVL ≥3+]. Of these, 54% (N = 6) showed signs of haemolysis. The majority were severely symptomatic [New York Heart Association ≥III (91%, N = 10)]. Procedural outcomes revealed no acute complications and no mortality. At discharge, PVL was completely eliminated in 91% (N = 10) of patients with 1 case of remaining moderate PVL. At 30 days, Mitral Valve Research Consortium device success was achieved in 82% (N = 9) of patients. Two patients required open surgical mitral valve replacement due to persistent and recurrent PVL. In 89% (N = 8) of patients with successful retensioning procedure, New York Heart Association class was I/II. There was no 30-day mortality. CONCLUSIONS This multicentre study demonstrates technical feasibility, procedural safety and acute efficacy of retensioning procedures in the majority of patients. The potential to retension the tether in transapical TMVI may provide additional management advantages in populations at high surgical risk.
Collapse
Affiliation(s)
- Martin Beyer
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - David Muller
- Cardiology Department, St Vincent's Hospital, Sydney, NSW, Australia
| | - Federico De Marco
- Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy
| | - Vinay Badhwar
- Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA
| | - Jean-Francois Obadia
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, Lyon, France
| | - Fabien Praz
- Department of Cardiology, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Thomas Modine
- Department of Cardiology and Cardiovascular Surgery, Heart Valve Center, Institut Cœur Poumon CHU de Bordeaux, Bordeaux, France
| | - Pim Tonino
- Department of Cardiology, Catharina Hospital, Eindhoven, Netherlands
| | - Gry Dahle
- Department of Cardiothoracic Surgery, Oslo University Hospital, Norway
| | - Alfredo Cerillo
- Department of Cardiac Surgery, Careggi University Hospital, Florence, Italy
| | - Sebastian Ludwig
- Department of Cardiology, University Heart & Vascular Center Hamburg, Hamburg, Germany
- German Center for Cardiovascular Research: DZHK, Partner Site Hamburg/Kiel/Lübeck, Germany
| | - Lenard Conradi
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany
| |
Collapse
|
2
|
Nucera M, Miazza J, Praz F, Kaiser C, Siepe M, Reineke D, Reuthebuch O. Transapical Transcatheter Mitral Valve Implantation with the Tendyne Valve: The Swiss Experience. Thorac Cardiovasc Surg 2023. [PMID: 37327913 DOI: 10.1055/s-0043-1769099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND The aim of this study was to report outcomes of all patients undergoing transcatheter mitral valve implantation with the Tendyne Mitral Valve System (Tendyne) in Switzerland. METHODS We retrospectively analyzed preoperative echocardiographic and computed tomography (CT) data, procedural findings, and 30-day and 1-year follow-up echocardiographic and clinical data of patients who underwent transcatheter mitral valve implantation with Tendyne in Switzerland. RESULTS A total of 24 patients (age, 74.8 ± 7.8 years; 67% male) underwent transapical transcatheter mitral valve implantation with Tendyne between June 2020 and October 2022. Technical success rate was 96%. In five patients, concomitant interventions in the form of transcatheter aortic valve implantation (one patient), minimally invasive direct coronary artery bypass (one patient), and transcatheter edge-to-edge repair (three patients) were performed prior to or after the index procedure. There was one device embolization, and two patients required valve retrieval. In-hospital outcomes included one stroke and three major bleeding events. None of the patients died within 30 days. Two patients were rehospitalized for decompensated heart failure. At 1-year follow-up, there were three noncardiovascular-related deaths. CONCLUSION Transcatheter mitral valve implantation with Tendyne is feasible to treat polymorbid patients suffering from complex mitral valve disease as well as patients with previous mitral interventions. Perioperative risk was acceptable and procedural success high.
Collapse
Affiliation(s)
- Maria Nucera
- Department of Cardiac Surgery, Cardiovascular Center, Inselspital University Hospital Bern, Bern, Switzerland
| | - Jules Miazza
- Department of Cardiac Surgery, Universitätsspital Basel, Basel, BS, Switzerland
| | - Fabien Praz
- Department of Cardiology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Christoph Kaiser
- Department of Cardiology, Universitätsspital Basel, Basel, BS, Switzerland
| | - Matthias Siepe
- Department of Cardiac Surgery, Cardiovascular Center, Inselspital University Hospital Bern, Bern, Switzerland
| | - David Reineke
- Department of Cardiac Surgery, Cardiovascular Center, Inselspital University Hospital Bern, Bern, Switzerland
| | - Oliver Reuthebuch
- Department of Cardiac Surgery, Universitätsspital Basel, Basel, BS, Switzerland
| |
Collapse
|
3
|
Kettritz R, Düttmann W, Brand A, Luft FC. The Case | Is this hemolytic uremic syndrome? Kidney Int 2022; 102:1195-1196. [PMID: 36272747 DOI: 10.1016/j.kint.2022.04.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Ralph Kettritz
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité-Universitätsmedizin, Berlin, Germany
| | - Wiebke Düttmann
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anna Brand
- Department of Cardiology and Angiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedrich C Luft
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité-Universitätsmedizin, Berlin, Germany.
| |
Collapse
|
4
|
Wild MG, Kreidel F, Hell MM, Praz F, Mach M, Adam M, Reineke D, Ruge H, Ludwig S, Conradi L, Rudolph TK, Bleiziffer S, Kellermair J, Zierer A, Nickenig G, Weber M, Petronio AS, Giannini C, Dahle G, Rein KA, Coisne A, Vincentelli A, Dubois C, Duncan A, Quarto C, Unbehaun A, Amat‐Santos I, Cobiella J, Dumonteil N, Estevez‐Loureiro R, Fumero A, Geisler T, Lurz P, Mangieri A, Monivas V, Noack T, Nombela Franco L, Pinon MA, Stolz L, Tchétché D, Walter T, Unsöld B, Baldus S, Andreas M, Hausleiter J, Bardeleben RS. Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real‐world multicentre experience. Eur J Heart Fail 2022; 24:899-907. [DOI: 10.1002/ejhf.2434] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/27/2021] [Accepted: 01/10/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Mirjam G. Wild
- Medizinische Klinik I LMU University Hospital Munich Germany
- Department of Cardiology Inselspital University Hospital Bern Bern Switzerland
| | - Felix Kreidel
- Department of Cardiology University Medical Center Mainz Mainz Germany
| | - Michaela M. Hell
- Department of Cardiology University Medical Center Mainz Mainz Germany
| | - Fabien Praz
- Department of Cardiology Inselspital University Hospital Bern Bern Switzerland
| | - Markus Mach
- Department of Cardiac Surgery Medical University of Vienna Vienna Vienna Austria
| | - Matti Adam
- Department of Cardiology University Hospital Cologne Cologne Germany
| | - David Reineke
- Department of Cardiac Surgery Inselspital University Hospital Bern Bern Switzerland
| | - Hendrik Ruge
- Department of Cardiovascular Surgery German Heart Center, Munich, Technical University Munich Germany
| | - Sebastian Ludwig
- Department of Cardiology University Hospital Hamburg Hamburg Germany
| | - Leonard Conradi
- Department of Cardiology University Hospital Hamburg Hamburg Germany
| | - Tanja K. Rudolph
- Department of Cardiology Heart‐ und Diabetes Center Nordrhine‐Westfalia, Bad Oeynhausen, Ruhr‐University Bochum Germany
| | - Sabine Bleiziffer
- Department of Cardiology Heart‐ und Diabetes Center Nordrhine‐Westfalia, Bad Oeynhausen, Ruhr‐University Bochum Germany
| | - Jörg Kellermair
- Department of Cardiology Kepler University Hospital Linz Austria
| | - Andreas Zierer
- Department of Cardiology Kepler University Hospital Linz Austria
| | - Georg Nickenig
- Department of Cardiac Surgery University Hospital Bonn Bonn Germany
| | - Marcel Weber
- Department of Cardiology University Hospital Bonn Bonn Germany
| | | | | | - Gry Dahle
- Department of Cardiothoracic surgery Oslo University Hospital Oslo Norway
| | - Kjell A. Rein
- Department of Cardiothoracic surgery Oslo University Hospital Oslo Norway
| | - Augustin Coisne
- Université Lille, Inserm, CHU Lille, Institut Pasteur de Lille U1011‐ EGID Lille France
| | - André Vincentelli
- Université Lille, Inserm, CHU Lille, Institut Pasteur de Lille U1011‐ EGID Lille France
| | - Christophe Dubois
- Department of cardiovascular medicine acute and interventional cardiology, UZ Leuven Leuven Belgium
| | - Alison Duncan
- Department of Cardiology Royal Brompton Hospital London United Kingdom
| | - Cesare Quarto
- Department of Cardiac Surgery Royal Brompton Hospital London United Kingdom
| | - Axel Unbehaun
- Department of Cardiac Surgery German Heart Center Berlin Germany
| | - Ignacio Amat‐Santos
- Department of Cardiology CIBER‐CV, University Clinic Hospital Valladolid Valladolid Spain
| | - Javier Cobiella
- Department of Cardiology Hospital Clínico San Carlos Madrid Spain
| | | | | | - Andrea Fumero
- Department of Biomedical Sciences Humanitas University, Pieve Emanuele‐Milan, Italy; Humanitas Research Hospital IRCCS Rozzano‐Milan Italy
| | - Tobias Geisler
- Department of Cardiology University Hospital Tuebingen Tuebingen Germany
| | - Philipp Lurz
- Department of Cardiology Heart Center Leipzig Leipzig Germany
| | - Antonio Mangieri
- Department of Biomedical Sciences Humanitas University, Pieve Emanuele‐Milan, Italy; Humanitas Research Hospital IRCCS Rozzano‐Milan Italy
| | - Vanessa Monivas
- Department of Cardiology Puerta de Hierro Hospital Madrid Spain
| | - Thilo Noack
- University Department of Cardiac Surgery Heart Center Leipzig Leipzig Germany
| | | | - Miguel A. Pinon
- Department of Cardiology University Hospital Alvaro Cunqueiro Vigo Spain
| | - Lukas Stolz
- Medizinische Klinik I LMU University Hospital Munich Germany
| | | | - Thomas Walter
- Department of Cardiac Surgery University Hospital Frankfurt Frankfurt Germany
| | - Bernhard Unsöld
- Department of Internal Medicine II University Hospital Regensburg Regensburg Germany
| | - Stephan Baldus
- Department of Cardiology University Hospital Cologne Cologne Germany
| | - Martin Andreas
- Department of Cardiac Surgery Medical University of Vienna Vienna Vienna Austria
| | - Jörg Hausleiter
- Medizinische Klinik I LMU University Hospital Munich Germany
| | | | | |
Collapse
|