Predicting paravalvular leak after transcatheter mitral valve replacement using commercially available software modeling

2020 ◽  
Vol 14 (6) ◽  
pp. 495-499 ◽  
Author(s):  
Michael F. Morris ◽  
Alejandro Pena ◽  
Aneesh Kalya ◽  
Abhishek C. Sawant ◽  
Kapildeo Lotun ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Paravalvular Leak ◽  
Software Modeling ◽  
Transcatheter Mitral Valve Replacement

scholarly journals Software Modeling to Predict Paravalvular Leak Following Transcatheter Mitral Valve Replacement

2018 ◽  
Vol 11 (20) ◽  
pp. e167-e169 ◽  
Author(s):  
Michael F. Morris ◽  
Mohamad Lazkani ◽  
Matthew Stanich ◽  
H. Kenith Fang ◽  
Ashish Pershad
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Paravalvular Leak ◽  
Software Modeling ◽  
Transcatheter Mitral Valve Replacement

scholarly journals A tensed Tendyne

2020 ◽  
Vol 58 (3) ◽  
pp. 651-653 ◽  
Author(s):  
Daniel Grinberg ◽  
Matteo Pozzi ◽  
Chloé Bernard ◽  
Jean-Francois Obadia
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Paravalvular Leak ◽  
Main Challenge ◽  
Low Profile ◽  
Transcatheter Mitral Valve Replacement ◽  
Left Ventricular Outflow

Abstract We report a case of prosthesis dislodgement after transcatheter mitral valve replacement in an 85-year-old woman with chronic ischaemic heart failure. Two weeks after an initial successful implantation, she presented with a paravalvular leak associated with left ventricular outflow tract obstruction. Tether re-tensioning was performed and resolved the situation, but resulted in a deformation of the apical attachment zone into the left ventricle. Unfortunately, the patient finally expired from severe endocarditis. Proper anchoring is the main challenge for transcatheter mitral valve replacement techniques. Dislodgement of the prosthesis after transcatheter mitral valve replacement is an infrequent complication of the Tendyne® procedure. This case emphasizes the importance of assessing the quality of the myocardium at the implantation zone of the apical pad, and of prosthesis oversizing, especially if low-profile valves are chosen. .

scholarly journals Tableside Skirt Modification of the SAPIEN 3 Valve to Reduce Paravalvular Leak During Transcatheter Mitral Valve Replacement

2021 ◽  
Vol 14 (8) ◽  
pp. 932-934
Author(s):  
Adam B. Greenbaum ◽  
Emily Perdoncin ◽  
Gaetano Paone ◽  
Kendra J. Grubb ◽  
Joe X. Xie ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Paravalvular Leak ◽  
Transcatheter Mitral Valve Replacement ◽  
Sapien 3

scholarly journals Multimodality Cardiac Imaging for Procedural Planning and Guidance of Transcatheter Mitral Valve Replacement and Mitral Paravalvular Leak Closure

2021 ◽  
Vol 8 ◽  
Author(s):  
Enrique Garcia-Sayan ◽  
Tiffany Chen ◽  
Omar K. Khalique
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Cardiac Imaging ◽  
Mitral Annulus ◽  
Fusion Imaging ◽  
Paravalvular Leak ◽  
Transcatheter Mitral Valve Replacement ◽  
Transcatheter Valve ◽  
Procedural Planning

Transcatheter mitral valve interventions are an evolving and growing field in which multimodality cardiac imaging is essential for diagnosis, procedural planning, and intraprocedural guidance. Currently, transcatheter mitral valve-in-valve with a balloon-expandable valve is the only form of transcatheter mitral valve replacement (TMVR) approved by the FDA, but valve-in-ring and valve-in-mitral annular calcification interventions are increasingly being performed. Additionally, there are several devices under investigation for implantation in a native annulus. Paravalvular leak (PVL) is a known complication of surgical or transcatheter valve implantation, where regurgitant flow occurs between the prosthetic sewing ring and the native mitral annulus. We sought to describe the role and applications of multimodality cardiac imaging for TMVR, and PVL closure, including the use of Cardiovascular Computed Tomography Angiography and 3-Dimensional Transesophageal Echocardiography for diagnosis, prosthetic valve evaluation, pre-procedural planning, and intraprocedural guidance, as well as evolving technologies such as fusion imaging and 3D printing.

scholarly journals ‘Minimalist approach’ for transcatheter mitral valve replacement using intracardiac echocardiography and conscious sedation: a case series

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Robert J Cubeddu ◽  
Abdullah Sarkar ◽  
Viviana Navas ◽  
Jose L Navia
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Conscious Sedation ◽  
Intracardiac Echocardiography ◽  
Paravalvular Leak ◽  
Invasive Technique ◽  
Transcatheter Mitral Valve Replacement ◽  
Minimalist Approach ◽  
Prosthetic Mitral Valve

Abstract Background Transcatheter aortic valve implantation operators have adapted to a less invasive technique by foregoing the use of general anaesthesia and transoesophageal echocardiography. This is known as a ‘minimalist approach’. This approach has yet to be explored in transcatheter mitral valve replacement (TMVR). Two patients with high perioperative risk underwent TMVR using only monitored conscious sedation (CS) and intracardiac echocardiography (ICE). Case summary The patients were symptomatic and required treatment of severe mitral regurgitation and severe mitral stenosis in a mitral valve ring and prosthetic mitral valve, respectively. With the use of an antegrade transseptal approach, the procedure was conducted under CS using ICE only. After placement of the prosthetic mitral valve, the valve was assessed by advancing the ICE catheter through the interatrial septal defect and no significant paravalvular leak occurred. In one case, ad hoc treatment of right to left shunting was successfully pursued. Valve function was excellent immediately and at 24 h after implantation and resulted in significant haemodynamic improvement. Conclusion With more TMVR cases being conducted, the ‘minimalist approach’ with CS and ICE may be considered in selected cases.

scholarly journals Tip-to-Base LAMPOON for Transcatheter Mitral Valve Replacement With a Protected Mitral Annulus

2021 ◽  
Vol 14 (5) ◽  
pp. 541-550 ◽  
Author(s):  
John C. Lisko ◽  
Vasilis C. Babaliaros ◽  
Jaffar M. Khan ◽  
Norihiko Kamioka ◽  
Patrick T. Gleason ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Annulus ◽  
Transcatheter Mitral Valve Replacement

Left ventricular remodeling after transcatheter mitral valve replacement with Tendyne

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Fukui ◽  
P Sorajja ◽  
M Goessl ◽  
R Bae ◽  
B Sun ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Ventricular Remodeling ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Reverse Remodeling ◽  
Functional Changes ◽  
Transcatheter Mitral Valve Replacement ◽  
Lv Mass

Abstract Background Data on changes in left atrial (LA) and left ventricular (LV) volumes after transcatheter mitral valve replacement (TMVR) are limited. Purpose This study sought to describe the anatomical and functional changes in left-sided cardiac chambers by computed tomography angiography (CTA) from baseline to 1-month after TMVR with Tendyne prosthesis. Methods We analyzed patients who underwent TMVR with Tendyne prosthesis (Abbott Structural, Menlo Park, CA) between 2015 and 2018. Changes in LV end-diastolic volume (LVEDV), ejection fraction (LVEF), mass (LV mass), LA volume and global longitudinal strain (GLS) were assessed at baseline and at 1-month after TMVR with CTA. Specific Tendyne implant characteristics were identified and correlated with remodeling changes. Results A total of 36 patients (mean age 73±8 years, 78% men, 86% secondary MR) were studied. There were significant decreases in LVEDV (268±68 vs. 240±66ml, p<0.001), LVEF (38±10 vs. 32±11%, p<0.001), LV mass (126±37 vs. 117±32g, p<0.001), LA volume (181±74 vs. 174±70 ml, p=0.027) and GLS (−12.6±5.1 vs. −9.5±4.0%, p<0.001) from baseline to 1-month follow-up. Favorable LVEDV reverse-remodeling occurred in the majority (30 of 36 patients, or 83%). Closer proximity of the Tendyne apical pad to the true apex was predictive of favorable remodeling (pad distance: 25.0±7.7 vs. 33.5±8.8mm, p=0.02 for those with and without favorable remodeling). Conclusions TMVR with Tendyne results in favorable left-sided chamber remodeling in the majority of patients treated, as detected on CTA at 1-month after implantation. CTA identifies the favorable post-TMVR changes, which could be related to specific characteristics of the device implantation. Funding Acknowledgement Type of funding source: None

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