scholarly journals Case report: Buddy wire technique to facilitate atrial septal crossing during transcatheter transseptal mitral valve implantation

2020 ◽  
Author(s):  
Ashvarya Mangla ◽  
Ameer Musa ◽  
Clifford J Kavinsky ◽  
Hussam S Suradi
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Heart Valve ◽  
Interatrial Septum ◽  
Chronic Obstructive ◽  
Mitral Valve Stenosis ◽  
Heart Team ◽  
Transcatheter Heart Valve ◽  
Valve Implantation ◽  
Buddy Wire

Abstract Background Transcatheter mitral valve-in-valve implantation (MVIV) has emerged as a viable treatment option in patients at high risk for surgery. Occasionally, despite appropriate puncture location and adequate dilation, difficulty is encountered in advancing the transcatheter heart valve across interatrial septum. Case summary We describe a case of a 79-year-old woman with severe chronic obstructive pulmonary disease (COPD), prior surgical bioprosthetic aortic and mitral valve replacement implanted in 2007, atrial fibrillation, and Group II pulmonary hypertension who presented with progressively worsening heart failure symptoms secondary to severe bioprosthetic mitral valve stenosis and moderate-severe mitral regurgitation. Her symptoms had worsened over several months, with multiple admissions at other institutions with treatment for both COPD exacerbation and heart failure. Transoesophageal echocardiogram demonstrated preserved ejection fraction, normal functioning aortic valve, and dysfunctional mitral prosthesis with severe stenosis (mean gradient 13 mmHg) and moderate-severe regurgitation. After a multi-disciplinary heart team discussion, the patient underwent a transcatheter MVIV implantation. During the case, inability in advancing the transcatheter heart valve (THV) across interatrial septum despite adequate septal balloon pre-dilation was successfully managed with the support of a stiff ‘buddy wire’ anchored in the left upper pulmonary vein using the same septal puncture. The patient tolerated the procedure well and was discharged home. Discussion Operators should be aware of potential strategies to advance the THV when difficulty is encountered in crossing the atrial septum despite adequate septal preparation. One such strategy is the use of stiff ‘buddy wire’ for support which avoids the need for more aggressive septal dilatation.

scholarly journals Incidence, clinical impact and treatment outcomes of valve thrombosis after transcatheter mitral valve implantation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Kikoine ◽  
M Urena ◽  
E Brochet ◽  
C Nguyen ◽  
J.L Carrasco ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Treatment Outcomes ◽  
Heart Valve ◽  
Vitamin K Antagonists ◽  
Anticoagulation Therapy ◽  
Transoesophageal Echocardiography ◽  
Clinical Impact ◽  
Transcatheter Heart Valve ◽  
Valve Thrombosis ◽  
Valve Implantation

Abstract Background Transcatheter mitral valve implantation (TMVI) is a new treatment option for high-risk surgical patients with degenerated bioprosthesis (ViV), failed annuloplasty rings (ViR) and severe mitral annular calcification (ViMAC). However, limited data exist on transcatheter heart valve thrombosis. Purpose The aim of this study was to report the incidence, clinical impact and treatment outcomes of transcatheter heart valve (THV) thrombosis in patients undergoing TMVI. Methods All consecutive patients undergoing TMVI in our center between July 2010 and September 2019 were included. A transoesophageal echocardiography and a computed tomography (CT) were performed before hospital discharge and at each clinical visit, at 3 months, at 1 year and yearly after. THV thrombosis was defined as the presence of at least one thickened leaflet with restricted motion suggestive of thrombus confirmed by TOE and/or contrast CT. All patients received anticoagulation therapy with vitamin K antagonists (VKA) and a low dose of aspirin for the first 3 months. Results A total of 132 patients underwent TMVI (62 ViV, 36 ViR and 34 ViMAC). Among them, 16 (12.1%) patients had a THV thrombosis. Median age was 67 years old and 56.2% of patients were women. Median time to diagnosis of THV thrombosis was 78 days. Early THV thrombosis was observed in 7 (43.7%) and in 13 (81.2%) patients THV thrombosis occurred within the first 6 months after the procedure. 8 out 9 patients with subacute or late THV thrombosis were not anticoagulated or with subtherapeutic anticoagulation. No stroke or thromboembolic events occurred in these patients. No change in mitral gradient was observed in 14 out 16 patients. VKA were indicated in all patients. THV thrombosis resolved in all but one patient. Conclusion THV thrombosis is frequent after TMVI, occurs mainly within the first 6-months after the procedure, are mostly subclinical and resolves after optimization of anticoagulation treatment. An anticoagulation therapy for at least 6 months may be necessary. Timing of THV thrombosis Funding Acknowledgement Type of funding source: None

scholarly journals One-shot transcatheter double valve replacement: six-month follow-up—a case report

2020 ◽  
Author(s):  
Georg Lutter ◽  
Mohamed Salem ◽  
Derk Frank ◽  
Thomas Puehler
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Young Patients ◽  
Heart Association ◽  
Left Ventricular ◽  
Mitral Valve Stenosis ◽  
Term Outcome ◽  
Transcatheter Mitral Valve Replacement ◽  
Valve Implantation

Abstract Background Transcatheter aortic valve replacement (TAVR) in combination with a valve-in-valve (V-i-V) transcatheter mitral valve replacement (TMVR) is a rare procedure in comparison to surgical therapy especially in young patients. We report on a young patient at high surgical risk, receiving a double valve implantation with two S3 transcatheter heart valves. Case summary A 59-year-old female patient with two previous mitral valve replacements due to endocarditis and re-endocarditis experienced a new onset of severe mitral valve stenosis in combination with progredient aortic stenosis. She was admitted to the hospital with severe dyspnoea and intermittent non-invasive ventilation [New York Heart Association (NYHA) III–IV]. An interventional transapical transcatheter double valve implantation was planned and carried out due to cardiac decompensation and high comorbidity preoperatively (STS score of 6.92). At 6-month follow-up, the patient presented herself in an improved condition with reduced symptoms (NYHA I–II), a good functional status of both valves and an advanced right and left ventricular function in the echocardiogram. Discussion Even in younger patients at high risk, a combined native TAVR and V-i-V TMVR procedure can be performed. In this case, a transcatheter SAPIEN 3 valve was transapically implanted with good clinical mid-term outcome at 6 months.

The Wattson temporary pacing guidewire for transcatheter heart valve implantation

2021 ◽  
Author(s):  
James Carey ◽  
Anthony Buckley ◽  
Stephen O'Connor ◽  
Mark Hensey
Keyword(s):  
Aortic Valve ◽  
Heart Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Pacemaker Implantation ◽  
Left Ventricular ◽  
Temporary Pacing ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Transcatheter aortic valve implantation and implantation of other transcatheter heart valves, generally requires insertion of a temporary venous pacemaker. Implantation of a temporary venous pacemaker adds complexity, time and risk to the procedure. Guidewire modification to allow pacing is increasingly popular, however it requires technical expertise and provides unipolar pacing resulting in high thresholds and potential capture loss. The Wattson temporary pacing guidewire is a novel device which offers guidewire support for valve delivery and concomitant bipolar pacing. It may offer a safe and effective solution to guidewire pacing for transcatheter aortic valve implantation and other transcatheter heart valve implantations. Herein, we review the literature surrounding left ventricular guidewire pacing along with the features and clinical data of the Wattson wire.

Von Willebrand factor in aortic or mitral valve stenosis and bleeding after heart valve surgery

2021 ◽  
Vol 198 ◽  
pp. 190-195
Author(s):  
Piotr Mazur ◽  
Joanna Natorska ◽  
Michał Ząbczyk ◽  
Łukasz Krzych ◽  
Radosław Litwinowicz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Heart Valve ◽  
Von Willebrand Factor ◽  
Valve Surgery ◽  
Mitral Valve Stenosis ◽  
Heart Valve Surgery ◽  
Von Willebrand ◽  
Willebrand Factor

Severe Preeclampsia Complicating Mitral Valve Stenosis

1998 ◽  
Vol 23 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Beatrice Afrangui ◽  
A. M. Malinow
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Thromboembolism ◽  
Severe Preeclampsia ◽  
Mitral Valve Stenosis ◽  
Previous Pregnancy ◽  
Invasive Hemodynamic Monitoring ◽  
Maternal And Neonatal Outcomes ◽  
Abdominal Delivery

Background and ObjectivesWe present a report of a parturient with severe mitral valve stenosis diagnosed during a previous pregnancy who developed severe preeclampsia.MethodsLabor and subsequent abdominal delivery were managed with epidural analgesia and anesthesia. The clinical management was guided by invasive hemodynamic monitoring, including a flow-directed pulmonary artery catheter.ConclusionsPeripartum maternal and neonatal outcomes were satisfactory. Postpartum complications included pulmonary edema as well as peripartum heart failure and pulmonary thromboembolism 4 weeks postpartum.

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