1
|
Agostini G, Vairo A, Montefusco A, Marro M, Costamagna A, La Torre MW, Trompeo AC, Pocar M, Rinaldi M, Salizzoni S. Transcatheter Mitral Valve Implantation in Failed Transventricular Mitral Valve Repair. JACC Case Rep 2024; 29:102273. [PMID: 38645293 PMCID: PMC11031677 DOI: 10.1016/j.jaccas.2024.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 04/23/2024]
Abstract
An 84-year-old man presented with dyspnea at rest due to severe mitral regurgitation. He first underwent transventricular mitral valve repair with the Harpoon system, which relapsed owing to rupture of neochords. He was definitively treated with transcatheter mitral valve implantation of the Tendyne system 8 months later.
Collapse
Affiliation(s)
- Giulia Agostini
- Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessandro Vairo
- Cardiac Division, Città della Salute e della Scienza, Turin, Italy
| | | | - Matteo Marro
- Cardiac Surgery, Città della Salute e della Scienza, Turin, Italy
| | - Andrea Costamagna
- Anesthesiology and Intensive Care Division, Department of Surgical Sciences, University of Turin, Turin, Italy
| | | | - Anna Chiara Trompeo
- Cardiovascular Anesthesia and Intensive Care Division, Città della Salute e della Scienza, Turin, Italy
| | - Marco Pocar
- Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Stefano Salizzoni
- Cardiac Surgery, Department of Surgical Sciences, University of Turin, Turin, Italy
| |
Collapse
|
2
|
Salizzoni S, Vairo A, Montefusco A, Alunni G, La Torre M, Agostini G, Pistono M, Faletti R, Rinaldi M, Vola M. A Mono-Leaflet, Low-Profile Transcatheter Mitral Prosthesis: First-in-Human Implantation. JACC Cardiovasc Interv 2023; 16:2918-2919. [PMID: 37943193 DOI: 10.1016/j.jcin.2023.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 11/10/2023]
Affiliation(s)
| | - Alessandro Vairo
- Cardiac Division, Città Della Salute e Della Scienza, Turin, Italy
| | | | - Gianluca Alunni
- Cardiac Division, Città Della Salute e Della Scienza, Turin, Italy
| | - Michele La Torre
- Cardiac Surgery Division, Città Della Salute e Della Scienza, Turin, Italy
| | - Giulia Agostini
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Massimo Pistono
- Division of Cardiac Rehabilitation of Veruno Institute, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno, Italy
| | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Mauro Rinaldi
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Marco Vola
- Cardiac Surgery Division, University of Lyon, Lyon, France
| |
Collapse
|
3
|
Suc G, Himbert D, Brochet E, Ducrocq G, Vahanian A, Urena M. Direct Transcatheter Mitral Valve-in-Ring Replacement to Treat a Failing Alfieri Valve Repair. JACC Cardiovasc Interv 2023; 16:1292-1294. [PMID: 37225297 DOI: 10.1016/j.jcin.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 05/26/2023]
Affiliation(s)
- Gaspard Suc
- Department of Cardiology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Unité mixte de recherche en santé 1148, Institut national de la santé et de la recherche médicale, Paris, France; Université de Paris, Paris, France
| | - Dominique Himbert
- Department of Cardiology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Unité mixte de recherche en santé 1148, Institut national de la santé et de la recherche médicale, Paris, France
| | - Eric Brochet
- Department of Cardiology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gregory Ducrocq
- Department of Cardiology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Unité mixte de recherche en santé 1148, Institut national de la santé et de la recherche médicale, Paris, France; Université de Paris, Paris, France
| | - Alec Vahanian
- Department of Cardiology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Unité mixte de recherche en santé 1148, Institut national de la santé et de la recherche médicale, Paris, France; Université de Paris, Paris, France
| | - Marina Urena
- Department of Cardiology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Unité mixte de recherche en santé 1148, Institut national de la santé et de la recherche médicale, Paris, France; Université de Paris, Paris, France.
| |
Collapse
|
4
|
Huczek Z, Mazurek M, Kochman J, Kralisz P, Jagielak D, Sacha J, Frank M, Targoński R, Walczak A, Rymuza B, Grodecki K, Scisło P, Jędrzejczyk S, Jańczak J, Pysz P, Rudziński PN, Demkow M, Witkowski A, Grygier M, Wojakowski W. Valve-in-valve transcatheter transfemoral mitral valve implantation (ViV-TMVI): Characteristics and early results from nationwide registry. Kardiol Pol 2023:VM/OJS/J/93805. [PMID: 37096948 DOI: 10.33963/kp.a2023.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 01/22/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Valve-in-valve transcatheter transfemoral mitral valve implantation (ViV-TMVI) is an emerging treatment alternative to reoperation in high surgical risk patients with a failed mitral bioprostheses. AIM To describe characteristics and evaluate 30-day outcomes of ViV-TMVI in the Polish population. METHODS Nationwide registry was initiated to collect data of all patients with failed mitral bioprosthesis undergoing ViV-TMVI in Poland. This study presents 30-days clinical and echocardiographic follow-up. RESULTS Overall, 27 ViV-TMVI were performed in 8 centers until May 2022 (85% since 2020). Mean (standard deviation [SD]) age was 73 (11.6) years with the median (interquartile range [IQR]) STS score of 5.3% (4.3%-14.3%). Mean (SD) time between surgical implantation and ViV-TMVI was 8.2 (3.2) years. Failed Hancock II (29%) and Perimount Magna (22%) were most frequently treated. Mechanisms of failure were equally often pure mitral regurgitation or stenosis (both 37%) with mixed etiology in 26%. Balloon-expandable Sapien 3/Ultra were used in all but 1 patient. Technical success was 96.3% (1 patient required additional prosthesis). Mean (SD) transvalvular mitral gradient reached 6.7 (2.2) mm Hg and mitral valve area was 1.8 (0.4) cm². None of the patients had moderate or severe mitral regurgitation with only 14.8% graded as mild. In 92.6% device success (2 patients had mean gradient ≥10 mm Hg) and in 85.6% procedural success was present. There were no deaths, cerebrovascular events or need for mitral valve surgery during 30-day follow-up. CONCLUSIONS In short-term observation ViV-TMVI is safe and effective alternative for patients with failed mitral bioprosthesis at high surgical risk of re-operation. Longer observations on larger sample are warranted.
Collapse
Affiliation(s)
- Zenon Huczek
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Maciej Mazurek
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland.
| | - Janusz Kochman
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Paweł Kralisz
- Department of Invasive Cardiology, Medical University of Białystok, Białystok, Poland
| | - Dariusz Jagielak
- Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland
| | - Jerzy Sacha
- Department of Cardiology, University Hospital in Opole, Opole, Poland
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Marek Frank
- Department of Cardiac Surgery, Medical University of Białystok, Białystok, Poland
| | - Radosław Targoński
- 1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Andrzej Walczak
- Department of Cardiac Surgery, Medical University of Łódz, Łódz, Poland
| | - Bartosz Rymuza
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Kajetan Grodecki
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Piotr Scisło
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Szymon Jędrzejczyk
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Jakub Jańczak
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Piotr Pysz
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Piotr Nikodem Rudziński
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warszawa, Poland
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warszawa, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Marek Grygier
- Chair and 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
5
|
Sá MP, Ramlawi B, Gray WA, Malin JH, Van den Eynde J, Sicouri S, Torregrossa G, Klein C, Heil E, Sündermann SH, Emmerich A, Kempfert J, Kofler M, Falk V, Unbehaun A, Van Praet KM. Transcatheter mitral valve implantation in the ongoing structural heart revolution. J Card Surg 2022; 37:1691-1704. [PMID: 35340080 DOI: 10.1111/jocs.16431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
Transcatheter mitral valve implantation (TMVI) has emerged as a less invasive approach potentially surmounting some of the current hurdles associated with transcatheter edge-to-edge repair and high-risk mitral valve surgery. In this review, we aimed to outline the main scenarios in the TMVI field, highlight current and upcoming devices, and describe challenges and clinical results. Finally, we briefly discuss the future perspectives for this emerging field and how TMVI might further advance the field of transcatheter treatments of mitral valve disease.
Collapse
Affiliation(s)
- Michel Pompeu Sá
- Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA.,Department of Cardiothoracic Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, USA
| | - Basel Ramlawi
- Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA.,Department of Cardiothoracic Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, USA
| | - William A Gray
- Department of Interventional Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, USA
| | - John H Malin
- Philadelphia College of Osteopathic Medicine, Bala Cynwyd, Pennsylvania, USA
| | - Jef Van den Eynde
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.,Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, Maryland, USA
| | - Serge Sicouri
- Department of Cardiothoracic Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, USA
| | - Gianluca Torregrossa
- Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, Pennsylvania, USA.,Department of Cardiothoracic Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, Pennsylvania, USA
| | - Christoph Klein
- Department of Internal Medicine-Cardiology, German Heart Center Berlin, Berlin, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Emanuel Heil
- Department of Internal Medicine-Cardiology, German Heart Center Berlin, Berlin, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Simon H Sündermann
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Emmerich
- Department of Anaesthesiology, German Heart Center Berlin, Berlin, Germany
| | - Jörg Kempfert
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Markus Kofler
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Volkmar Falk
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Department of Health Sciences and Technology, Institute of Translational Medicine, Swiss Federal Institute of Technology, Translational Cardiovascular Technologies, Zurich, Switzerland
| | - Axel Unbehaun
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Karel M Van Praet
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany.,Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| |
Collapse
|
6
|
Wu K, Gu S, Lu T, Dong S, Dong C, Huang H, Liu Z, Zhang X, Zhou Y. Feasibility evaluation of the transapical saddle-shaped valved stent for transcatheter mitral valve implantation. J Card Surg 2022; 37:1537-1543. [PMID: 35315544 PMCID: PMC9315026 DOI: 10.1111/jocs.16426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/26/2022]
Abstract
Background and Aims of Study Transcatheter mitral valve implantation (TMVI) is a promising and minimally invasive treatment for high‐risk mitral regurgitation. We aimed to investigate the feasibility of a novel self‐expanding valved stent for TMVI via apical access. Methods We designed a novel self‐expanding mitral valve stent system consisting of an atrial flange and saddle‐shaped ventricular body connected by two opposing anchors and two opposing extensions. During valve deployment, each anchor was controlled by a recurrent string. TMVI was performed in 10 pigs using the valve prosthesis through apical access to verify technical feasibility. Echocardiography and ventricular angiography were used to assess hemodynamic data and valve function. Surviving pigs were killed 4 weeks later to confirm stent deployment. Results Ten animals underwent TMVI using the novel mitral valve stent. Optimal valve deployment and accurate anatomical adjustments were obtained in nine animals. Implantation failed in one case, and the animal died 1 day later due to stent mismatch. After stent implantation, the hemodynamic parameters of the other animals were stable, and valve function was normal. The mean pressure across the mitral valve and left ventricular outflow tract were 2.98 ± 0.91 mmHg and 3.42 ± 0.66 mmHg, respectively. Macroscopic evaluation confirmed the stable and secure positioning of the stents. No obvious valve displacement, embolism, or paravalvular leakage was observed 4 weeks postvalve implantation. Conclusions This study demonstrated that the novel mitral valve is technically feasible in animals. However, the long‐term feasibility and durability of this valved stent must be improved and verified.
Collapse
Affiliation(s)
- Kaiqin Wu
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shaorui Gu
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tiancheng Lu
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shengting Dong
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chenglai Dong
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haitao Huang
- Department of Thoracic and Cardiovascular Surgery, Nantong First People's Hospital, Nantong, China
| | - Zhenchuan Liu
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xin Zhang
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yongxin Zhou
- Department of Thoracic-Cardiovascular Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| |
Collapse
|
7
|
Bartkowiak J, Reineke D, Tomii D, Brugger N, Pilgrim T, Terbeck S, Khan JM, Windecker S, Lanz J, Praz F. Electrosurgical Laceration and Stabilization of MitraClip Followed by Valve Implantation for Iatrogenic Mitral Stenosis. JACC Cardiovasc Interv 2021; 15:110-112. [PMID: 34922889 DOI: 10.1016/j.jcin.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Joanna Bartkowiak
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland.
| | - David Reineke
- Department of Cardiac Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Daijiro Tomii
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Nicolas Brugger
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Thomas Pilgrim
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Sandra Terbeck
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jaffar M Khan
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Stephan Windecker
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Jonas Lanz
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| | - Fabien Praz
- Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland
| |
Collapse
|
8
|
Nakashima M, Williams M, He Y, Latson L, Saric M, Vainrib A, Staniloae C, Hisamoto K, Ibrahim H, Querijero M, Tovar J, Kalish C, Pushkar I, Jilaihawi H. Multiphase Assessment of Mitral Annular Dynamics in Consecutive Patients With Significant Mitral Valve Disease. JACC Cardiovasc Interv 2021; 14:2215-2227. [PMID: 34600871 DOI: 10.1016/j.jcin.2021.06.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aim of this study was to clarify the dynamics of the mitral annulus throughout the cardiac cycle and its relevance to transcatheter mitral valve replacement (TMVR) sizing and case selection. BACKGROUND Limited data are available regarding the relevance of mitral annular (MA) and neo-left ventricular outflow tract (LVOT) dynamics in the overall population presenting with significant mitral valve disease. METHODS Patients attending a combined surgical-transcatheter heart valve clinic for severe symptomatic mitral valve disease were assessed using multiphase computed tomography. The relative influence of MA and neo-LVOT dynamics to TMVR case selection was studied. RESULTS A total of 476 patients with significant mitral valve disease were evaluated. In 99 consecutive patients with severe mitral regurgitation, a 10-phase assessment showed that the mitral annulus was on average largest in late systole. On comparing maximal MA dimension with late systolic dimension, TMVR size assignment changed in 24.2% of patients. If the average MA perimeter was used to determine sizing, 48.5% were excluded because of MA dimension being too large; in a multiphase assessment of the neo-LVOT, an additional 16.2% were excluded on the basis of neo-LVOT dimension. In an expanded series of 312 consecutive patients, selection protocol influenced anatomical exclusion: a manufacturer-proposed early systolic approach excluded 69.2% of patients, whereas a late systolic approach excluded 82.7% of patients, the vast majority because of large mitral annuli. CONCLUSIONS Contemporary TMVR can treat only a minority of patients with severe mitral regurgitation, principally because of limitations of large MA dimension.
Collapse
Affiliation(s)
| | - Mathew Williams
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Yuxin He
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Larry Latson
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Muhamed Saric
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Alan Vainrib
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Cezar Staniloae
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | | | - Homam Ibrahim
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | | | - Joseph Tovar
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Chloe Kalish
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Illya Pushkar
- Heart Valve Center, NYU Langone Health, New York, New York, USA
| | - Hasan Jilaihawi
- Heart Valve Center, NYU Langone Health, New York, New York, USA.
| |
Collapse
|
9
|
Puehler T, Saad M, Haneya A, Frank D, Lutter G. Rendezvous of CoreValve Skirt With Tendyne Crown. JACC Cardiovasc Interv 2021; 14:2073-2074. [PMID: 34454854 DOI: 10.1016/j.jcin.2021.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Thomas Puehler
- Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts University of Kiel School of Medicine, Kiel, Germany; Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - Mohammed Saad
- Department of Cardiology and Angiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Assad Haneya
- Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Derk Frank
- Department of Cardiology and Angiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Georg Lutter
- Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts University of Kiel School of Medicine, Kiel, Germany; Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| |
Collapse
|
10
|
Urena M, Lemann T, Chong-Nguyen C, Brochet E, Ducrocq G, Carrasco JL, Iung B, Vahanian A, Himbert D. Causes and predictors of mortality after transcatheter mitral valve implantation in patients with severe mitral annulus calcification. Catheter Cardiovasc Interv 2021; 98:981-989. [PMID: 34263517 DOI: 10.1002/ccd.29874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/13/2021] [Accepted: 07/05/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To evaluate the causes and predictors of mortality after valve-in-mitral annulus calcification (MAC) transcatheter mitral valve implantation (TMVI). BACKGROUND Conventional surgical mitral valve replacement is associated with a high risk in patients with mitral valve disease associated with severe MAC. In this population, TMVI may be an attractive alternative option. However, its prognostic factors are poorly understood. METHODS All patients undergoing valve-in-MAC TMVI from 2013 to 2018 in our center were included. Indication for TMVI relied on the judgment of the local heart team. Patients were followed at 30 days and 1 year. RESULTS A total of 34 patients underwent valve-in-MAC TMVI. The mean age was 79 ± 11 years and 73% of patients were women. Their mean EuroSCORE 2 was 8 ± 7%. The transseptal approach was used in 79% of patients and a hybrid transatrial in 29%. Balloon expandable transcatheter heart valves were used in all the patients. Technical success was achieved in 76% of the patients. Thirty-day and 1-year all-cause mortality rates were 14.7% and 32.4%, respectively. The main two causes of 1-year mortality were congestive heart failure (8.8%) and infective endocarditis (5.9%). In multivariate analysis, the only predictor of 1-year mortality was the presence of periprothetic mitral regurgitation grade 2 (HR, 5.69; 95%CI, 1.59-27.88, p = 0.032). CONCLUSION Early and mid-term mortality remains high after valve-in-MAC TMVI and seems to be associated with the presence of paravalvular mitral regurgitation. However, whether the latter is a prognostic factor or marker remains to be determined to improve clinical outcomes in this high-risk population.
Collapse
Affiliation(s)
- Marina Urena
- University of Paris, Paris, France.,Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France.,INSERM U 1148, Paris, France
| | - Thomas Lemann
- Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France
| | - Caroline Chong-Nguyen
- Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France
| | - Eric Brochet
- Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France
| | - Grégory Ducrocq
- University of Paris, Paris, France.,Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France.,INSERM U 1148, Paris, France
| | - Jose-Luis Carrasco
- Assistance Publique - Hôpitaux de Paris, Department of Anaesthesiology, Bichat-Claude Bernard Hospital, Paris, France
| | - Bernard Iung
- University of Paris, Paris, France.,Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France.,INSERM U 1148, Paris, France
| | - Alec Vahanian
- University of Paris, Paris, France.,INSERM U 1148, Paris, France
| | - Dominique Himbert
- Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat-Claude Bernard Hospital, Paris, France.,INSERM U 1148, Paris, France
| |
Collapse
|
11
|
Ruge H, Xhepa E, Joner M, König C, Ried T, Imeri E, Herold U, Krane M, Lange R, Erlebach M. First-in-Man Simultaneous Aortic and Mitral Valve Transcatheter Implantation Using Patient-Customized Prostheses. JACC Case Rep 2021; 3:653-657. [PMID: 34317597 PMCID: PMC8302802 DOI: 10.1016/j.jaccas.2021.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/29/2020] [Accepted: 01/22/2021] [Indexed: 06/13/2023]
Abstract
Valve disease in the presence of porcelain aorta and severe peripheral artery disease challenge physicians in choosing the appropriate therapy. We used a total transcatheter approach, simultaneously implanting a dedicated mitral and aortic valve prosthesis treating a patient with mitral and aortic valve disease at an extremely high surgical risk. (Level of Difficulty: Advanced.).
Collapse
Affiliation(s)
- Hendrik Ruge
- Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany
- INSURE (Institute of Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
| | - Erion Xhepa
- Cardiology Department, German Heart Centre Munich, Munich, Germany
| | - Michael Joner
- Cardiology Department, German Heart Centre Munich, Munich, Germany
| | - Christian König
- Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany
- INSURE (Institute of Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
| | - Thomas Ried
- Institute of Anaesthesiology, German Heart Centre Munich, Munich, Germany
| | - Emin Imeri
- Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany
- INSURE (Institute of Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
| | - Ulf Herold
- Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany
- INSURE (Institute of Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
| | - Markus Krane
- Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany
- INSURE (Institute of Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
| | - Ruediger Lange
- Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany
- INSURE (Institute of Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
| | - Magdalena Erlebach
- Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany
- INSURE (Institute of Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany
| |
Collapse
|
12
|
Morita S, Takahashi S, Pernot M, Leroux L, Labrousse L. Open heart mitral valve replacement using the Edwards-Sapien 3 for severe mitral annular calcification prevents left ventricular outflow tract obstruction. Clin Case Rep 2021; 9:1424-1427. [PMID: 33768859 PMCID: PMC7981714 DOI: 10.1002/ccr3.3796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/23/2020] [Accepted: 12/29/2020] [Indexed: 11/22/2022] Open
Abstract
Open heart transcatheter mitral valve implantation using the Edwards-Sapien 3 for mitral annular calcification is a safe procedure, because surgeons do not have to decalcify. And also, surgeons can resect the anterior mitral leaflet to prevent left ventricular outflow tract obstruction and deploy the valve under direct visualization.
Collapse
Affiliation(s)
- Shohei Morita
- Department of Cardiovascular SurgeryHiroshima University HospitalHiroshimaJapan
| | - Shinya Takahashi
- Department of Cardiovascular SurgeryHiroshima University HospitalHiroshimaJapan
| | - Mathieu Pernot
- Medico‐Surgical Department of ValvulopathiesHaut Leveque HospitalBordeauxFrance
| | - Lionel Leroux
- Medico‐Surgical Department of ValvulopathiesHaut Leveque HospitalBordeauxFrance
| | - Louis Labrousse
- Medico‐Surgical Department of ValvulopathiesHaut Leveque HospitalBordeauxFrance
| |
Collapse
|
13
|
Lisko JC, Greenbaum AB, Guyton RA, Kamioka N, Grubb KJ, Gleason PT, Byku I, Condado JF, Jadue A, Paone G, Block PC, Alvarez L, Xie J, Khan JM, Rogers T, Lederman RJ, Babaliaros VC. Electrosurgical Detachment of MitraClips From the Anterior Mitral Leaflet Prior to Transcatheter Mitral Valve Implantation. JACC Cardiovasc Interv 2020; 13:2361-2370. [PMID: 33011144 PMCID: PMC7584767 DOI: 10.1016/j.jcin.2020.06.047] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/20/2020] [Accepted: 06/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to test the hypothesis that transcatheter electrosurgery might allow intentional detachment of previously placed MitraClip(s) from the anterior leaflet to recreate a single mitral orifice for transcatheter mitral valve implantation (TMVI), leaving the retained MitraClip(s) securely fastened to the posterior leaflet and without interfering with the mitral bioprosthesis. BACKGROUND Patients with severe mitral regurgitation or stenosis despite edge-to-edge mitral repair with the MitraClip typically have few therapeutic options because the resultant double orifice precludes TMVI. Transcatheter electrosurgery may allow detachment of failed MitraClip(s) from the anterior leaflet to recreate a single orifice for TMVI. METHODS This was a single-center, 5-patient, consecutive, retrospective observational cohort. Patients underwent transcatheter electrosurgical laceration and stabilization of failed MitraClip(s) to recreate a single orifice, leaving the MitraClip(s) securely fastened to the posterior leaflet. Subsequently, patients underwent TMVI with an investigational device, the Tendyne mitral bioprosthesis, on a compassionate basis. Patients were followed up to 30 days. RESULTS MitraClip detachment from the anterior leaflet and Tendyne implantation were successful in all patients. All patients survived to discharge. All patients were discharged with grade 0 central mitral regurgitation. Two patients had moderate perivalvular mitral regurgitation that did not require reintervention. During the follow-up period of 30 days, there were no deaths, cases of valve dysfunction, or reintervention. There was no evidence of erosion or bioprosthetic valve dysfunction attributable to the retained MitraClip(s) still attached to the posterior leaflet. CONCLUSIONS Transcatheter electrosurgical detachment of failed MitraClips from the anterior leaflet followed by TMVI is technically feasible and safe at 30 days. Longer term study is needed to determine the clinical benefit of this approach and new algorithms for TMVI sizing following electrosurgical laceration and stabilization of a failed MitraClip to avoid perivalvular leak.
Collapse
Affiliation(s)
- John C Lisko
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Adam B Greenbaum
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Robert A Guyton
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Norihiko Kamioka
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Kendra J Grubb
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Patrick T Gleason
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Isida Byku
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Jose F Condado
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Andres Jadue
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Gaetano Paone
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Peter C Block
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Lucia Alvarez
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Joe Xie
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia
| | - Jaffar M Khan
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Toby Rogers
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Robert J Lederman
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Vasilis C Babaliaros
- Division of Cardiology, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia.
| |
Collapse
|
14
|
Ukaigwe AC, Sorajja P, Hashimoto G, Lopes B, Gössl M. Challenges of Left Atrial Appendage Occlusion Using a Watchman After Transcatheter Mitral Valve Implantation With a Tendyne. JACC Cardiovasc Interv 2020; 13:1720-2. [PMID: 32473889 DOI: 10.1016/j.jcin.2020.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 11/21/2022]
|
15
|
Ukaigwe A, Gössl M, Cavalcante J, Olson S, Sorajja P. Neo-Left Ventricular Outflow Tract Modification With Alcohol Septal Ablation Before Tendyne Transcatheter Mitral Valve Replacement. JACC Cardiovasc Interv 2020; 13:2078-2080. [PMID: 32535004 DOI: 10.1016/j.jcin.2020.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/29/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Anene Ukaigwe
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Mario Gössl
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - João Cavalcante
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Sara Olson
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Paul Sorajja
- Center for Valve and Structural Heart Disease, Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota.
| |
Collapse
|
16
|
Koh JQ, Walton A, Marasco S, Duffy SJ. Transcatheter Mitral Valve Implantation with the Medtronic Intrepid™ Transcatheter Mitral Valve Replacement System. Future Cardiol 2019; 15:281-293. [PMID: 31074640 DOI: 10.2217/fca-2018-0082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Mitral regurgitation is the most prevalent yet undertreated valvulopathy despite its adverse prognosis. With the emergence of transcatheter mitral interventions, the potential for this huge unmet disease burden to be addressed may finally be realized. Medtronic Intrepid™ Transcatheter Mitral Valve Replacement System represents one of several novel solutions. Based on early data from the pilot study, its efficacy and clinical utility is currently being tested against the mainstay treatment of surgical mitral valve replacement in a randomized trial. While there remain significant challenges before transcatheter mitral intervention can become part of the routine treatment algorithm, the authors are optimistic that transcatheter mitral valve repair and intervention have the potential in revolutionizing the management of severe symptomatic mitral regurgitation.
Collapse
Affiliation(s)
- Ji Qs Koh
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Antony Walton
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Silvana Marasco
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, Victoria, Australia
| | - Stephen J Duffy
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Epidemiology & Preventive Medicine, Centre of Cardiovascular Research & Education in Therapeutics, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
17
|
Abstract
Background Valvular heart disease is an important cause of morbidity and mortality throughout the world; in industrialized nations, mitral regurgitation (MR) is the most common valvular lesion. Untreated, severe MR has a poor prognosis, with a 5-year mortality rate of up to 50%. Surgical repair of symptomatic, severe primary MR has been demonstrated to improve survival. The aim of this review is to assess the early outcomes of newly developed transcatheter mitral valve implantation technologies for the treatment of secondary native valve disease. Furthermore, the outcomes of patients receiving transcatheter treatment of regurgitant failure of surgically repaired or replaced mitral valve has also been addressed. Methods A systematic review of twenty-five studies assessing the outcomes of patients undergoing transcatheter mitral valve implantation for native mitral regurgitation or failed prior surgical repair or bioprosthetic replacement was carried out. Results The outcomes of 112 patients undergoing transcatheter mitral valve replacement for secondary mitral regurgitation using six different valve systems were assessed. There were 15 early deaths and 24 deaths over the follow-up period. The outcomes of 44 patients undergoing transcatheter valve-in-valve replacement were assessed with an overall mortality of ten patients. There were 20 patients included who had valve-in-ring transcatheter mitral replacement for previous failed repair. The total mortality was five patients during the follow-up period. Conclusions Transcatheter mitral valve implantation represents a new evolution in management of valvular disease and affords management options to patients who historically may not have been offered treatment. Early results have demonstrated some promise and improvements in technology, imaging modalities and patient selection will surely result in a reliable and durable valve.
Collapse
Affiliation(s)
- Campbell D Flynn
- Department of Cardiothoracic Surgery, Royal North Shore Hospital, St Leonards, Australia.,CORE Research Group, Macquarie University, Sydney, Australia
| | - Ashley R Wilson-Smith
- CORE Research Group, Macquarie University, Sydney, Australia.,School of Medicine, Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Tristan D Yan
- CORE Research Group, Macquarie University, Sydney, Australia.,School of Medicine, Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Camperdown, Australia.,Sydney Adventist Hospital, University of Sydney, Sydney, Australia
| |
Collapse
|
18
|
Ferrari E, Biasco L, Faletra F, Cheung A, Moccetti M, Pedrazzini G, Demertzis S, Moccetti T. Tiara Valve Implantation in a Patient With Previously Implanted Mono-disk Mechanical Aortic Prosthesis. Semin Thorac Cardiovasc Surg 2018. [PMID: 29518534 DOI: 10.1053/j.semtcvs.2018.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Transcatheter mitral valve replacement with the Tiara valve can be performed in inoperable patients with severe functional regurgitation. Risk of left ventricular outflow tract obstruction can be prevented using preoperative 3D imaging and 3D-printed models. However, in the case of mono-disk mechanical prostheses previously implanted in aortic position (Bjork-Shiley), there is an additional risk of mechanical interference leading to reduced leaflet motion and aortic valve dysfunction. Hereafter, we describe the case of a patient with a 27-mm mono-disk mechanical aortic valve implanted in 1978, a EuroSCORE II of 18%, and a Society of Thoracic Surgeon score (mortality) of 16% who successfully underwent a transapical Tiara valve implantation.
Collapse
Affiliation(s)
- Enrico Ferrari
- Cardiac Surgery Department, Cardiocentro Ticino Foundation, Lugano, Switzerland.
| | - Luigi Biasco
- Cardiology Department, Cardiocentro Ticino Foundation, Lugano, Switzerland
| | - Francesco Faletra
- Cardiology Department, Cardiocentro Ticino Foundation, Lugano, Switzerland
| | - Anson Cheung
- Cardiac Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Marco Moccetti
- Cardiology Department, Cardiocentro Ticino Foundation, Lugano, Switzerland
| | | | - Stefanos Demertzis
- Cardiac Surgery Department, Cardiocentro Ticino Foundation, Lugano, Switzerland
| | - Tiziano Moccetti
- Cardiology Department, Cardiocentro Ticino Foundation, Lugano, Switzerland
| |
Collapse
|
19
|
Karaskov MA, Zhuravleva YI, Bogachev-Prokophiev VA, Demidov PD. [Transcatheter Implantation of Mitral Valve Prostheses: Current Status of the Problem]. Kardiologiia 2017; 57:51-59. [PMID: 29041893 DOI: 10.18087/cardio.2017.8.10018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mitral valve disease is highly prevalent and quickly leads to development of severe heart failure. Mitral valve disease of degenerative or ischemic etiology affects 7.5 and 9.3% of population older than 65 and 75 years, respectively. "Open" (with cardiopulmonary bypass) surgical repair or valve replacement are not possible in almost half of affected patients because of their complications and concomitant diseases responsible for extremely high risk of these interventions. In the last decade, minimally invasive endovascular technology - transcatheter aortic valve implantation (TAVI) - has been widely introduced for correction of aortic valve disease in similar category of patients. However, transcatheter mitral valve implantation (TMVI) has been developed just during recent couple of years.
Collapse
Affiliation(s)
- M A Karaskov
- Federal State Budgetary Institution "Academician E.N. Meshalkin Siberian Biomedical Research Center" of the Ministry of Health of the Russian Federation
| | - Y I Zhuravleva
- Federal State Budgetary Institution "Academician E.N. Meshalkin Siberian Biomedical Research Center" of the Ministry of Health of the Russian Federation
| | - V A Bogachev-Prokophiev
- Federal State Budgetary Institution "Academician E.N. Meshalkin Siberian Biomedical Research Center" of the Ministry of Health of the Russian Federation
| | - P D Demidov
- Federal State Budgetary Institution "Academician E.N. Meshalkin Siberian Biomedical Research Center" of the Ministry of Health of the Russian Federation
| |
Collapse
|
20
|
Kapadia SR, Mentias A, Barakat AF, Raza MQ, Lal Poddar K, Baeza C, Maluenda G, Navia J, Schoenhagen P, Murat Tuzcu E. Relationship of mitral valve annulus plane and circumflex-right coronary artery plane: Implications for Transcatheter Mitral Valve Implantation. Catheter Cardiovasc Interv 2016; 89:932-943. [PMID: 27218261 DOI: 10.1002/ccd.26575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 04/22/2016] [Indexed: 12/15/2022]
Abstract
AIM Transcatheter mitral valve implantation (TMVI) is a novel technology for patients with severe mitral valve disease but at high surgical risk. Imaging guidance during the procedure is critical for successful device deployment. Identification of the mitral annular plane (MAP) with fluoroscopy during the procedure is limited by lack of clearly defined landmarks. We hypothesized that a plane defined by left circumflex-right coronary arteries (LCX-RCA) would have a consistent relationship to MAP. METHODS AND RESULTS We studied 25 patients with gated cardiac computed tomography. We identified the MAP and the LCX-RCA plane in mid systole and diastole. The distance between the two planes in prespecified four points (anterior, posterior, medial, and lateral) in the apical 2 and 3-chamber views. Alignment of the planes was described by cranial/caudal angulation for both planes in RAO 30° and LAO 90° (lateral) angulation. Mean age was 81 ± 9 years, 56% of patients had ≥2+ mitral regurgitation. In mid systole, the distances between the LCX-RCA plane and the MAP in the four points were < 5 mm in 92% of patients. In mid diastole, distances were < 5 mm in 100% of patients. In mid systole, the correlation between the caudal/cranial orientations of the 2 planes was 0.85 and 0.80 in the LAO 90° and RAO 30°, respectively (P = <0.001). In mid diastole, this was 0.92 and 0.92 in the LAO 90° and RAO 30°, respectively (P = <0.001). CONCLUSION LCX-RCA plane has a close and consistent relationship to the MAP and can be useful to guide TMVI. Accurate imaging of mitral valve annular plane during TMVI procedure is challenging. MAP guided by fluoroscopy might be crucial to guide successful prosthesis deployment. A plane defined by the left circumflex- right coronary arteries in the atrioventricular grove has a consistent relationship with MAP; this can be used aided by pre-procedural MDCT to guide TMVI procedure. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Samir R Kapadia
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| | - Amgad Mentias
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| | - Amr F Barakat
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| | - Mohammad Q Raza
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| | - Kanhaiya Lal Poddar
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| | - Cristian Baeza
- Department of cardiovascular medicine, San Borja Arriaran Hospital, Cardiovascular Center, Santiago, Chile
| | - Gabriel Maluenda
- Department of cardiovascular medicine, San Borja Arriaran Hospital, Cardiovascular Center, Santiago, Chile
| | - Jose Navia
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| | - Paul Schoenhagen
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| | - E Murat Tuzcu
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Ohio
| |
Collapse
|
21
|
Affiliation(s)
- Anita W Asgar
- Montreal Heart Institute, Université de Montreal, Montreal, Quebec, Canada.
| |
Collapse
|
22
|
Xu B, Gooley R, Seneviratne SK, Nasis A. Clinical utility of multi-detector cardiac computed tomography in structural heart interventions. J Med Imaging Radiat Oncol 2016; 60:299-305. [PMID: 26849957 DOI: 10.1111/1754-9485.12441] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/04/2016] [Indexed: 01/05/2023]
Abstract
In recent years, there have been major advances in structural interventional cardiology, which have revolutionized the practice of cardiology. Appropriate selection and follow-up of patients undergoing these structural heart interventions is vital. Multi-detector computed tomography (MDCT) has emerged as a key imaging modality in the peri-procedural assessment of patients undergoing multiple structural cardiac interventions. The purpose of this review is to provide an evidence-based clinical update on the roles of MDCT in both established and evolving structural heart interventions, including transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve implantation (TMVI). The utility of MDCT in the peri-procedural assessment of patients undergoing pulmonary vein isolation (PVI) for atrial fibrillation, cardiac resynchronization therapy (CRT) and left atrial appendage (LAA) closure will also be reviewed.
Collapse
Affiliation(s)
- Bo Xu
- MonashHEART, Monash Health, Melbourne, Victoria, Australia
| | - Robert Gooley
- MonashHEART, Monash Health, Melbourne, Victoria, Australia
| | | | - Arthur Nasis
- MonashHEART, Monash Health, Melbourne, Victoria, Australia
| |
Collapse
|
23
|
Abdul-Jawad Altisent O, Dumont E, Dagenais F, Sénéchal M, Bernier M, O'Connor K, Paradis JM, Bilodeau S, Pasian S, Rodés-Cabau J. Transcatheter Mitral Valve Implantation With the FORTIS Device: Insights Into the Evaluation of Device Success. JACC Cardiovasc Interv 2015; 8:994-5. [PMID: 26003029 DOI: 10.1016/j.jcin.2015.01.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 12/22/2014] [Accepted: 01/15/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Eric Dumont
- Quebec Heart & Lung Institute, Quebec City, Quebec, Canada
| | | | - Mario Sénéchal
- Quebec Heart & Lung Institute, Quebec City, Quebec, Canada
| | | | - Kim O'Connor
- Quebec Heart & Lung Institute, Quebec City, Quebec, Canada
| | | | | | - Sergio Pasian
- Quebec Heart & Lung Institute, Quebec City, Quebec, Canada
| | | |
Collapse
|