Temporal Trends in Left and Right Heart Remodeling Following Transcatheter Edge-to-Edge Mitral Repair for Degenerative Mitral Regurgitation

2021 ◽  
Author(s):  
Andrew C. Peters ◽  
Marysa Leya ◽  
Abigail Baldridge ◽  
Vikrant Jagadeesan ◽  
Charles J. Davidson ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Temporal Trends ◽  
Right Heart ◽  
Heart Remodeling ◽  
Mitral Repair ◽  
Left And Right

scholarly journals Outcome after percutaneous edge-to-edge mitral repair for functional and degenerative mitral regurgitation: a systematic review and meta-analysis

Heart ◽  
2017 ◽  
Vol 104 (4) ◽  
pp. 306-312 ◽  
Author(s):  
Mauro Chiarito ◽  
Matteo Pagnesi ◽  
Enrico Antonio Martino ◽  
Michele Pighi ◽  
Andrea Scotti ◽  
...  
Keyword(s):  
Systematic Review ◽  
New York ◽  
Mitral Regurgitation ◽  
Meta Analysis ◽  
Heart Association ◽  
Class Iii ◽  
Term Outcome ◽  
Mitral Repair ◽  
New York Heart Association ◽  
One Year

ObjectivesDifferences in terms of safety and efficacy of percutaneous edge-to-edge mitral repair between patients with functional and degenerative mitral regurgitation (MR) are not well established. We performed a systematic review and meta-analysis to clarify these differences.MethodsPubMed, EMBASE, Google scholar database and international meeting abstracts were searched for all studies about MitraClip. Studies with <25 patients or where 1-year results were not delineated between MR aetiology were excluded. This study is registered with PROSPERO.ResultsA total of nine studies investigating the mid-term outcome of percutaneous edge-to-edge repair in patients with functional versus degenerative MR were included in the meta-analysis (n=2615). At 1 year, there were not significant differences among groups in terms of patients with MR grade≤2 (719/1304 vs 295/504; 58% vs 54%; risk ratio (RR) 1.12; 95% CI: 0.86 to 1.47; p=0.40), while there was a significantly lower rate of mitral valve re-intervention in patients with functional MR compared with those with degenerative MR (77/1770 vs 80/818; 4% vs 10%; RR 0.60; 95% CI: 0.38 to 0.97; p=0.04). One-year mortality rate was 16% (408/2498) and similar among groups (RR 1.26; 95% CI: 0.90 to 1.77; p=0.18). Functional MR group showed significantly higher percentage of patients in New York Heart Association class III/IV (234/1480 vs 49/583; 16% vs 8%; p<0.01) and re-hospitalisation for heart failure (137/605 vs 31/220; 23% vs 14%; p=0.03). No differences were found in terms of single leaflet device attachment (25/969 vs 20/464; 3% vs 4%; p=0.81) and device embolisation (no events reported in both groups) at 1 year.ConclusionsThis meta-analysis suggests that percutaneous edge-to-edge repair is likely to be an efficacious and safe option in patients with both functional and degenerative MR. Large, randomised studies are ongoing and awaited to fully assess the clinical impact of the procedure in these two different MR aetiologies.

Early and Mid-term Results of Mitral Valve Repair in Patients with Degenerative Mitral Regurgitation

2021 ◽  
Author(s):  
Hasan Erdem ◽  
Emre Selçuk
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Survival Rates ◽  
Mitral Valve Regurgitation ◽  
Valve Repair ◽  
Repair Rate ◽  
Mitral Repair ◽  
Mid Term Results

Objectives: In this study, we present the mid-term results of patients who underwent valve repair due to degenerative mitral valve regurgitation in the first five years of our mitral valve repair program. Patients and Methods: In this retrospective study, all patients who were operated for degenerative mitral regurgitation by a single surgical team between 2013 and 2017 were investigated. We determined early and mid-term cumulative survival rates, repair failure and freedom from reoperation. In addition, as a specific subgroup, the results of patients under 18 years of age after mitral valve repair were investigated Results: Mitral repair was performed in 121 of 153 degenerative mitral regurgitation patients during the study period. The overall repair rate was 79%. Mitral valve repair rate increased significantly over years. The Median follow-up time was 63 (range 10-92) months. Early mortality was 2.5% (n=3 patients). During the follow-up period, moderate-to-severe mitral regurgitation was observed in 14 (11.8%) patients, mitral valve reoperation was required in 7 (5.9%) patients. Valve repair was performed in 4 of 7 patients under the age of 18. There was no pediatric case requiring reoperation during the follow-up period (median 46 months). Conclusion: Mid-term results of mitral valve repair in degenerative mitral valve patients are satisfactory. The success rate of repair increases in line with surgical experience.

scholarly journals Microinvasive Mitral Valve Surgery: A New Frontier to Tackle Mitral Regurgitation

2021 ◽  
Author(s):  
Solomon Seifu ◽  
Eduardo de Marchena
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Repair System ◽  
Valve Repair ◽  
Mitral Repair ◽  
New Frontier ◽  
Clinical Benefits

Microinvasive, catheter-based mitral valve repair of severe mitral regurgitation utilizes less invasive approaches with less procedural morbidity and mortality. The procedural steps and clinical benefits of the transcatheter transapical mitral valve annuloplasty (AMEND mitral repair implant) and transcatheter transapical chordal repair systems (Neochord DS 1000 device and Harpoon Mitral Valve Repair System) are reviewed in this manuscript.

scholarly journals Design and development of a catheter-based tunable device for percutaneous mitral repair through coronary sinus

2021 ◽  
Author(s):  
Ata Taghipour
Keyword(s):  
Mitral Regurgitation ◽  
Coronary Sinus ◽  
Cardiac Disease ◽  
Large Scale ◽  
Heart Association ◽  
Circumflex Artery ◽  
Fem Simulations ◽  
Left Circumflex Artery ◽  
Mitral Repair ◽  
Tunable Device

According to the American Heart Association, the cardiac disease accounts for over 800,000 deaths every year (1 of every 3 deaths) in the US alone. Mitral regurgitation, which occurs in 2% of the population, has become the dominant valvular disease contributing to the high death rate caused by cardiac disease. The existing percutaneous treatments of mitral regurgitation suffer from compression of left circumflex artery, limiting their performance and causing serious iatrogenic consequences. Moreover, they are not tunable resulting in limited functionality. In this thesis, a catheter-based tunable device is designed to be implanted inside the coronary sinus for improving mitral regurgitation grade while minimizing the applied force on the left circumflex artery. A comprehensive computed tomography scan image analysis and experiments are performed to extract the required information for the design of the device and its evaluation with FEM simulations. A new effective engagement mechanism for integrating the device with the steerable catheter is designed and tested through large-scale experiments. Additionally, a temperature insensitive force/torque sensor is designed for guiding and introducing the device. This sensor can also be used in other catheter-based devices such as cardiac ablation catheters. The sensing structure of the sensor and its sensing method are evaluated by FEM simulations and large-scale prototyping. The actual-scale prototype of the sensor is fabricated, and the experiments are performed for analyzing the static and dynamic response of the sensor and its temperature cross-sensitivity.

scholarly journals TCT-413 Left and Right Heart Catheterizations Utilizing the Radial Artery and Forearm Vein: a Single Center Experience

2012 ◽  
Vol 60 (17) ◽  
pp. B118
Author(s):  
Simone Muraglia ◽  
Giuseppe Braito ◽  
Michele Dallago ◽  
Alberto Menotti ◽  
Roberto Bonmassari
Keyword(s):  
Radial Artery ◽  
Single Center ◽  
Right Heart ◽  
Single Center Experience ◽  
Left And Right ◽  
Forearm Vein

Surgical repair of the mitral valve

2018 ◽  
Author(s):  
David Sidebotham ◽  
Alan Merry ◽  
Malcolm Legget ◽  
Gavin Wright
Keyword(s):  
Mitral Regurgitation ◽  
Surgical Repair ◽  
Surgical Techniques ◽  
Transoesophageal Echocardiography ◽  
Degenerative Disease ◽  
Systolic Anterior Motion ◽  
Mitral Repair ◽  
Assessment And Treatment ◽  
Secondary Mitral Regurgitation ◽  
Characteristic Features

Chapter 9 is a new chapter from earlier editions of Practical Perioperative Transoesophageal Echocardiography. In the first part of the chapter, the indications for MV repair are reviewed, and areas of controversy are highlighted. Next, the surgical techniques used for valve repair for different mitral pathologies are summarized, in particular the use of leaflet resection or neochordae for repair of degenerative disease. Considerations for minimally invasive mitral repair are briefly reviewed. The bulk of the chapter is given over to TOE assessment prior to, and following, surgical repair. Characteristic features of, and associated complications encountered with, different mitral pathologies are presented. In particular, the risk factors for post-operative systolic anterior motion (SAM) in patients with degenerative disease and failure of a reduction annuloplasty in patients with secondary mitral regurgitation are described. The final section of the chapter details the post-repair assessment, with an emphasis on the features of an optimal repair, quantifying residual mitral regurgitation, mechanisms of repair failure, and assessment and treatment of post-operative SAM.

Cardiac catheterization

2020 ◽  
pp. 71-105
Author(s):  
Andrew Mitchell ◽  
Giovanni Luigi De Maria ◽  
Adrian Banning
Keyword(s):  
Cardiac Catheterization ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Pressure Measurements ◽  
Right Heart ◽  
Non Invasive ◽  
Contrast Angiography ◽  
Doppler Techniques ◽  
Left And Right ◽  
Anatomical Information

Cardiac catheterization allows the invasive acquisition of haemodynamic data using direct and indirect pressure measurements and oxygen saturations, and provides anatomical information using contrast angiography. Right heart catheterization used to be a routine part of an invasive cardiac study. The increased accessibility and accuracy of non-invasive imaging (in particular, echocardiography and Doppler techniques), however, has reduced the need to perform right heart catheterization. This chapter describes the principal uses of cardiac catheterization, the basics of pressure waveforms, equipment required, accessing the left and right heart, left and right heart pressures and waveforms, how to perform calculations, and the techniques of ventriculography and aortography.

scholarly journals Endoscopic Mitral Repair for Degenerative Mitral Regurgitation: Effect of Disease Complexity on Short- and Mid-term Outcomes

CJC Open ◽  
2020 ◽  
Vol 2 (5) ◽  
pp. 337-343
Author(s):  
Fadi Hage ◽  
Ali Hage ◽  
Usha Manian ◽  
Nikolaos Tzemos ◽  
Michael W.A. Chu
Keyword(s):  
Mitral Regurgitation ◽  
Mitral Repair
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