scholarly journals Transseptal Transcatheter Mitral Valve Replacement Using Balloon-Expandable Transcatheter Heart Valves

2017 ◽  
Vol 10 (19) ◽  
pp. 1905-1919 ◽  
Author(s):  
Marina Urena ◽  
Dominique Himbert ◽  
Eric Brochet ◽  
Jose Luis Carrasco ◽  
Bernard Iung ◽  
...  
2018 ◽  
Vol 44 (01) ◽  
pp. 038-045 ◽  
Author(s):  
Sabato Sorrentino ◽  
Gennaro Giustino ◽  
Kamilia Moalem ◽  
Ciro Indolfi ◽  
Roxana Mehran ◽  
...  

AbstractTranscatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies. As for biological surgical-type valves, transcatheter implanted valves still preserve the risk of thrombosis and embolic events and anticoagulation- or antiplatelet-based strategies are the most widely used options. Unfortunately, these last remain recommended on the basis of empirical or not widely validated evidence. Therefore, given the exponential rise of TAVR and TMVR procedures, it is important to identify the optimal antithrombotic strategies that best fit the risk of thromboembolic and bleeding events. Hereafter, this review evaluates the current guidelines, trials, and observational data discussing antithrombotic strategy after transcatheter aortic or mitral valve replacement.


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

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Fukui ◽  
P Sorajja ◽  
M Goessl ◽  
R Bae ◽  
B Sun ◽  
...  

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


2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Coisne ◽  
F Pontana ◽  
S Aghezzaf ◽  
S Mouton ◽  
H Ridon ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background.  3-dimensional transoesophageal echocardiography (3D-TEE) is frequently used as an initial screening tool in the evaluation of patients who are candidates to Transcatheter Mitral Valve Replacement (TMVR). However, little is known about the imaging correlation with the gold-standard computed tomography (CT) imaging. We aimed at testing the quantitative differences between these two modalities and finding the best 3D-TEE parameters for TMVR screening. Methods. We included 57 patients referred to our Heart Valve Clinic for TMVR with prostheses specifically designed for the mitral valve. Mitral annulus (MA) analyses were performed using commercially available software in 3D-TEE and CT. Results. 3D-TEE was feasible in 52 patients (91%). Although 3D-TEE measurements were slightly lower than in CT, both measurements of projected MA area and perimeter showed excellent correlation with small differences between the two modalities (r = 0.88 and r = 0.92 respectively, p < 0.0001). Correlations were significant but lower for MA diameters (r = 0.68 to 0.72, p < 0.0001) and mitro-aortic angle (r = 0.53, p = 0.0001). ROC curve analyses showed that 3D-TEE had a good ability to predict TMVR screening success defined by constructors based on CT measurements with a range of 12.9 to 15cm² for MA area (AUC = 0.88-0.91, p < 0.0001), 128 to 139mm for MA perimeter (AUC = 0.85-0.91, p < 0.0001), 35 to 39mm for anteroposterior diameter (AUC = 0.79-0.84 p < 0.0001) and 37 to 42mm for posteromedial-anterolateral diameter (AUC = 0.81-0.89, p < 0.0001) (Figure 1). Conclusion. 3D-TEE measurements of MA dimensions display strong correlation with CT measurements in patients undergoing TMVR screening process. 3D-TEE should be proposed as a reasonable alternative to CT in this vulnerable population. Abstract Figure.


2015 ◽  
Vol 8 (5) ◽  
pp. 612-615 ◽  
Author(s):  
Philipp Blanke ◽  
Danny Dvir ◽  
Anson Cheung ◽  
Robert A. Levine ◽  
Christopher Thompson ◽  
...  

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