scholarly journals Simultaneous transapical transcatheter aortic and mitral valve replacement in a high-risk patient with a previous mitral bioprosthesis

2012 ◽  
Vol 144 (3) ◽  
pp. e90-e91 ◽  
Author(s):  
Adil H. Al Kindi ◽  
Khaled F. Salhab ◽  
Samir Kapadia ◽  
Eric E. Roselli ◽  
Amar Krishnaswamy ◽  
...  
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
High Risk Patient ◽  
Risk Patient ◽  
Mitral Bioprosthesis

scholarly journals Totally Thoracoscopic Redo Mitral Valve Replacement for a High-Risk Patient Following Failed MitraClip Procedure

2021 ◽  
Vol 24 (5) ◽  
pp. E898-E900
Author(s):  
Peijian ◽  
Weitao Zhuang ◽  
Yanjun Liu ◽  
Jiexu Ma ◽  
Wei Zhu ◽  
...  
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Surgical Intervention ◽  
Open Heart Surgery ◽  
High Risk Patient ◽  
Risk Patient ◽  
Open Heart

The wide adoption of the MitraClip procedure in clinical practice inevitably causes increases in surgical intervention demand for patients following failed MitraClip implantation. Current reports about surgical intervention after failed MitraClip procedure focused on open-heart surgery. In this case, totally thoracoscopic third-time redo mitral valve replacement was successfully performed for a high-risk patient, following aortic valve replacement and a failed MitraClip procedure.

scholarly journals Transseptal transcatheter mitral valve implantation versus redo surgical mitral valve replacement for degenerated mitral bioprostheses

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Fuchs ◽  
B Iung ◽  
C Nguyen ◽  
J.L Carrasco ◽  
C Cimadevilla ◽  
...  
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Event Free Survival ◽  
Free Survival ◽  
Risk Patients ◽  
Valve Implantation ◽  
Mitral Bioprosthesis

Abstract Background The growing use of surgical bioprostheses raises concerns about a future reoperation for bioprosthesis degeneration. There are few data on outcome after transcatheter mitral valve-in-valve implantation (TMVI) compared with redo surgical mitral valve replacement (SMVR). Purpose To compare the feasibility, safety and outcomes of TMVI versus SMVR for degenerated mitral bioprosthesis in high-risk patients. Methods In our institution, 52 patients underwent TMVI by transseptal approach and 33 SMVR for degenerated mitral bioprosthesis. The composite endpoint of event-free survival included cardiovascular mortality, stroke, major bleeding, hospitalization for heart failure or mitral valve reintervention. Results Mean age and EuroSCORE II were higher in TMVI group vs. SMVR group (age 63±21 years vs. 51±15 years, p=0.002; EuroSCORE II 12.5±12.2% vs. 6.2±3.3%, p=0.001) (Table). In-hospital mortality was 3.8% after TMVI vs. 3.0% after SMVR (p=1.0). Median follow-up was 2.2 years. At 5 years, survival was 69.7±9.4% after TMVI vs. 86.6±7.6% after SMVR (p=0.10) and event-free survival was lower after TMVI (40.1±9.9% vs 78.7±8.8% respectively, p=0.003) (Figure). In multivariate analysis, older age (p=0.02), neurologic history (p=0.05) and non-elective procedure (p<0.0001) were associated with lower event-free survival, while TMVI vs. SMVR was no longer significant (p=0.17). At last follow-up, 84% patients from TMVI group and 78% from SMVR group were NYHA I-II class. Mean mitral valve gradient and pulmonary artery systolic pressure were respectively 6.8±2.5 mmHg and 45±14 mmHg in TMVI group, and 4.8±2.0 mmHg and 37±11 mmHg in SMVR group. Conclusion TMVI is an alternative to SMVR in high-risk patients with degenerated mitral bioprosthesis. Comparison of mid-term results of the two techniques must take into account the differences in patient characteristics. Event-free survival Funding Acknowledgement Type of funding source: None

scholarly journals Case report of successful low-dose, ultra-slow infusion thrombolysis of prosthetic mitral valve thrombosis in a high risk patient after redo-mitral valve replacement

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5
Author(s):  
Ioannis Kapos ◽  
Tobias Fuchs ◽  
Felix C Tanner
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Prosthetic Valve ◽  
Low Dose ◽  
Therapeutic Option ◽  
High Risk Patient ◽  
Normal Dose ◽  
Valve Thrombosis

Abstract Background An increase in transvalvular pressure gradient of prosthetic valve should always raise suspicion for obstructive valve thrombosis. A multimodality diagnostic approach including transthoracic echocardiography, transoesophageal echocardiography (TOE), cinefluoroscopy, or computed tomography (CT) is necessary for a prompt diagnosis. The management of mechanical prosthetic valve thrombosis (PVT) is high risk in any therapeutic option taken. Emergency valve replacement is recommended for critically ill patients. Fibrinolysis is an alternative for patients with contraindication to surgery or if surgery is not immediately available. Case summary A 52-year-old woman presented with symptoms and signs of cardiac congestion. On laboratory, brain natriuretic peptide was elevated and international normalized ratio (INR) was in subtherapeutic range. She underwent a mitral valve replacement with mechanical prosthesis 7 months before, because of a significant residual regurgitation after repair on the same year. TOE revealed severe stenosis of the prosthesis with immobile anterior disc but there was no mass present. CT revealed a minor lesion at the hinge points of the prosthesis without involvement of the ring, suggestive for thrombus. The initial fruitless management with intravenous (i.v) heparin in high therapeutic range was followed by a successful ‘low-dose, ultra-slow’ fibrinolysis. Discussion CT may help differentiate thrombus vs. pannus. The acute onset of symptoms, inadequate anticoagulation, and restricted leaflet motion increased the suspicion for PVT. The current European guidelines propose normal dose fibrinolysis. We performed ‘low-dose, ultra-slow’ fibrinolysis due to lower bleeding risk with successful results. Low dose should be considered as alternative to normal dose fibrinolysis or urgent surgery.

Postoperative Nesiritide Use following High-Risk Mitral Valve Replacement

2004 ◽  
Vol 7 (3) ◽  
pp. E189-E190 ◽  
Author(s):  
John W. C. Entwistle, III ◽  
David E. McLoughlin ◽  
Kourosh Baghelai
Keyword(s):  
High Risk ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement

Acquired submitral aneurysms may be associated with mitral paravalvular leaks

2021 ◽  
pp. 021849232110063
Author(s):  
Palaparti Raghuram ◽  
Kothandam Sivakumar ◽  
Ejaz Ahamed Sheriff
Keyword(s):  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Transcatheter Closure ◽  
Alternative Solution ◽  
Surgical Trauma ◽  
Ideal Solution ◽  
Repeat Surgery

Acquired submitral aneurysm after mitral valve replacement is caused by weakness of the annular tissues induced by inflammation, scarring, and ischemia from surgical trauma. The asynchronous stretch of the annulus caused by the submitral aneurysm may cause recurrent paravalvular leaks. In patients with acquired submitral aneurysms and paravalvular leaks, ideal solution is a repeat surgery to address both the aneurysm and the leak. However, when patients are at high risk for repeat surgeries on cardiopulmonary bypass through sternotomy, transcatheter closure of these paravalvar leaks may offer an alternative solution. Four such procedures in three patients are detailed in this report.

Direct Transcatheter Valve Deployment via Sternotomy for Complex Aortic Valve Reoperation

2019 ◽  
Vol 14 (4) ◽  
pp. 365-368
Author(s):  
Tom C. Nguyen ◽  
Alexander P. Nissen ◽  
Pranav Loyalka ◽  
Eyal E. Porat
Keyword(s):  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
High Risk Patient ◽  
Direct Vision ◽  
Risk Patient ◽  
Transcatheter Aortic Valve ◽  
Valve In Valve

Reoperative aortic valve replacement is associated with increased morbidity. Valve-in-valve transcatheter aortic valve replacement offers a less invasive alternative to traditional reoperation. However, cases of valve failure after valve-in-valve transcatheter aortic valve replacement represent a complex surgical challenge. We present a case requiring a complex reoperative aortic valve replacement due to structural valve deterioration after multiple previous valve-in-valve transcatheter aortic valve replacements. We performed removal of 3 previous valve-in-valve transcatheter aortic valves, bioprosthetic leaflet excision, and intentional bioprosthetic fracture under direct vision for annular enlargement. This facilitated direct insertion of a new transcatheter aortic valve for expedient and successful management of recurrent aortic stenosis in a very high-risk patient. Creative use of leaflet excision, intentional bioprosthetic fracture, and insertion of a new transcatheter aortic valve under direct vision, proved efficient and successful in a high-risk patient with few surgical options.

scholarly journals Minimally invasive aortic valve replacement in high risk patient groups

2017 ◽  
Vol 9 (6) ◽  
pp. 1672-1696 ◽  
Author(s):  
Daniel Fudulu ◽  
Harriet Lewis ◽  
Umberto Benedetto ◽  
Massimo Caputo ◽  
Gianni Angelini ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
High Risk Patient ◽  
Risk Patient ◽  
Patient Groups
Sign in / Sign up

Export Citation Format

Share Document