scholarly journals TCT CONNECT-337 Comparative Outcomes of Mitral Valve in Valve Implantation vs. Redo Mitral Valve Replacement for Degenerated Bioprostheses

2020 ◽  
Vol 76 (17) ◽  
pp. B145
Author(s):  
Mohammed Osman ◽  
Mohammed Al-Hijji ◽  
Akram Kawsara ◽  
Brijesh Patel ◽  
Mohamad Alkhouli
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Valve In Valve ◽  
Valve Implantation

scholarly journals Valve-in-Valve and Valve-in-Ring Transcatheter Mitral Valve Implantation in Young Women Contemplating Pregnancy

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Adeline Fuchs ◽  
Marina Urena ◽  
Caroline Chong-Nguyen ◽  
John Kikoïne ◽  
Eric Brochet ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Young Women ◽  
Left Ventricular ◽  
Systolic Pulmonary Artery Pressure ◽  
Vaginal Deliveries ◽  
Valve In Valve ◽  
Valve Implantation

Background: Transcatheter mitral valve implantation (TMVI) is emerging as an alternative to surgical mitral valve replacement in selected high-risk patients. Delaying definitive mechanical mitral valve replacement and the constraints of anticoagulation thanks to TMVI may be an attractive option in young women contemplating pregnancy and suffering from failure of mitral bioprosthesis or annuloplasty. The aim of the study was to evaluate the possibility, safety, and outcomes of pregnancy after TMVI in this population. Methods: From 2013 to 2019, 12 young women contemplating pregnancy underwent transseptal valve-in-valve or valve-in-ring TMVI using the Edwards SAPIEN XT/3 valves and were prospectively followed up at 1 month, 6 months, 1 year, and yearly thereafter. Results: Mean age of the patients was 30±6 years. Bioprosthesis degeneration was observed in 7 cases and annuloplasty failure in 5. Three valve-in-ring patients required the implantation of a second valve, which led to an overall procedural success rate of 75%. One delayed left ventricular outflow tract obstruction required elective surgical mitral valve replacement. At 6 months/1 year, 83% of the patients were in New York Heart Association classes I/II. Mitral regurgitation was ≤2+ in all the cases and mean gradient was 7±2 mm Hg. Four patients could complete 6 full-term pregnancies. One symptomatic thrombosis occurred and resolved under aspirin and anticoagulation therapy. All others pregnancies were uneventful. Predelivery mean gradient was 11 mm Hg, and systolic pulmonary artery pressure was 32 mm Hg. There were 4 vaginal deliveries and 2 cesarians. Newborns were alive and healthy. At last follow-up, there was no death, and 3 patients required elective surgical mitral valve replacement at 6- to 54-month follow-up. Conclusions: Our study suggests that, in young women, transseptal TMVI to treat failing bioprostheses may result in good short-term outcomes that allow uneventful pregnancies. The results are less favorable in women with failed annuloplasty rings.

scholarly journals Comparative Outcomes of Mitral Valve in Valve Implantation Versus Redo Mitral Valve Replacement for Degenerated Bioprotheses

2020 ◽  
Vol 132 ◽  
pp. 175-176
Author(s):  
Mohammed Osman ◽  
Mohammed A. Al-Hijji ◽  
Akram Kawsara ◽  
Brijesh Patel ◽  
Mohamad Alkhouli
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Valve In Valve ◽  
Valve Implantation

scholarly journals Mitral valve replacement after transcatheter aortic valve implantation in a patient with rheumatic heart disease and prior Ross procedure: a case report

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Khaled D. Algarni ◽  
Amr A. Arafat
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Ross Procedure ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Reoperations are required frequently after the Ross procedure in rheumatic patients. The use of transcatheter aortic valve implantation (TAVI) in those patients could decrease the risk of future open procedure; however, the outcome may be affected by the concomitant mitral valve disease, and subsequent mitral reoperation may distort the implanted aortic valve. Case presentation We present a female patient who had a beating mitral valve replacement after valve-in-valve TAVI in a patient with prior Ross procedure. Weaning from cardiopulmonary bypass was difficult, and the patient needed extra-cardiac membrane oxygenation (ECMO) and intra-aortic balloon pump because of right ventricular dysfunction. The right ventricular dysfunction could be due to the concomitant coronary artery disease or air embolism during the beating mitral valve surgery. Recovery was gradual, and the patient was discharged after 33 days. Pre-discharge echocardiography showed a maximum gradient of 9 mmHg on the aortic valve and mild paravalvular leak. Conclusions Mitral valve replacement in a patient with prior TAVI and the Ross procedure was feasible; it decreased the operative risk and did not distort the implanted aortic valve.

scholarly journals Acute and Short-Term Outcomes of Percutaneous Transcatheter Mitral Valve Replacement in Children

2021 ◽  
Author(s):  
Nicola Maschietto ◽  
Ashwin Prakash ◽  
Pedro del Nido ◽  
Diego Porras
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Pediatric Patients ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Surgical Risk ◽  
Transcatheter Mitral Valve Replacement ◽  
High Surgical Risk ◽  
Valve In Valve

Background: Despite the improvement of surgical techniques for mitral valve (MV) repair in children, mitral valve replacement (MVR) is sometimes still necessary. MVR and redo-MVR continue to be burdened by early postoperative mortality and long-term morbidity with only about 75% of these patients being alive or transplant-free 10 years after the initial MVR. Although transcatheter MVR (TMVR) is a well-established intervention in high surgical risk adults, only a few pediatric valve-in-valve case reports have been published. The purpose of this study was to describe our initial experience with the off-label use of the Sapien S3 valve for TMVR in a highly selected pediatric patient population. Methods: We conducted a retrospective analysis of pediatric patients who underwent TMVR at Boston Children’s Hospital between October 2018 and July 2020. Results: Eight consecutive high surgical risk pediatric patients (median age, 9 years; range, 8–15) underwent TMVR (7 as valve-in-valve, 1 in a native MV). Each patient previously underwent multiple MV surgeries or MVR (median 4, range 2–5) and was highly symptomatic (Ross functional class 3 or 4). The indication for TMVR was mitral stenosis in 4 patients, regurgitation in 1, and mixed disease in 3. TMVR was successful in each patient, effectively reduced the left atrium and pulmonary hypertension ( P =0.012 and 0.043 respectively), and was carried out without significant complications. Conclusions: TMVR is an attractive alternative to MVR in high surgical risk patients. In this small series, TMVR was acutely effective and safe, with very encouraging early results.

scholarly journals Transcatheter Mitral Valve Replacement: Evolution and Future Development

2021 ◽  
Author(s):  
Lina Ya’qoub ◽  
Marvin Eng
Keyword(s):  
Computed Tomography ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Future Research ◽  
Early Outcome ◽  
Transcatheter Mitral Valve Replacement ◽  
Valve In Valve ◽  
Procedural Planning ◽  
Annular Calcification

We will review transcatheter mitral valve replacement (TMVR) and discuss this evolving cutting edge procedure in terms of types (valve in valve, valve in ring and valve in mitral annular calcification MAC), clinical indications, pre-procedural planning and value of pre-procedural imaging including computed tomography role, technical challenges encountered in these procedures, potential complications for each type of TMVR, and potential strategies to mitigate and avoid such complications, We will review the currently available devices dedicated for mitral valve replacement, with a summary of their preliminary data and early outcome results. We will also discuss knowledge gaps and ideas for future research.

scholarly journals Immediate results of mitral valve-in-valve implantation for bioprosthetic valve dysfunction

2015 ◽  
Vol 19 (2) ◽  
pp. 36 ◽  
Author(s):  
L. S. Barbarash ◽  
A. N. Stasev ◽  
S. G. Kokorin ◽  
N. V. Rutkovskaya ◽  
I. N. Sizova
Keyword(s):  
Cardiovascular Diseases ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Bioprosthetic Valve ◽  
Advanced Age ◽  
Valve Dysfunction ◽  
Satisfactory Performance ◽  
Hospital Deaths ◽  
Valve In Valve ◽  
Valve Implantation

<p><strong>Background</strong>. Patients with bioprosthetic valve dysfunction have a higher risk for redo procedures because of advanced age, comorbidities and redo-related technical difficulties. Thus, valve-in-valve replacement seems to be an easier and safer option for this group of patients.<br />Objective. To assess the immediate results of mitral valve-in-valve implantation for bioprosthetic valve dysfunction.<br /><strong>Methods</strong>. 6 patients underwent mitral valve-in-valve implantation using “UniLine” prostheses at Kemerovo Research Institute for Complex Problems of Cardiovascular Diseases in 2014.<br /><strong>Results.</strong> There were no cases of in-hospital deaths and prosthesis-related complications in the group under study. Satisfactory performance of bioprostheses was confirmed by echocardiography offered to all the patients before their discharge. <br /><strong>Conclusion.</strong> Mitral valve-in-valve implantation for bioprosthetic valve dysfunction allows achieving satisfactory immediate results.</p>

Transcatheter Mitral Valve Implantation with the Medtronic Intrepid™ Transcatheter Mitral Valve Replacement System

2019 ◽  
Vol 15 (4) ◽  
pp. 281-293
Author(s):  
Ji QS Koh ◽  
Antony Walton ◽  
Silvana Marasco ◽  
Stephen J Duffy
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Disease Burden ◽  
Treatment Algorithm ◽  
Transcatheter Mitral Valve Repair ◽  
Transcatheter Mitral Valve Replacement ◽  
Replacement System ◽  
Valve Implantation

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.

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