scholarly journals Percutaneous Closure of Paravalvular Leak from a Rocking Mitral Valve in a 74-Year-Old Man at High Surgical Risk

2020 ◽  
Vol 47 (2) ◽  
pp. 160-162
Author(s):  
Frank E. Corrigan III ◽  
Jose Miguel Iturbe ◽  
Stamatios Lerakis ◽  
Norihiko Kamioka ◽  
Vasilis C. Babaliaros ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Heart Valve ◽  
Multimodal Imaging ◽  
Cardiac Cycle ◽  
Surgical Repair ◽  
Prosthetic Heart Valve ◽  
Paravalvular Leak ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Poor Outcomes

Dehiscence of a prosthetic heart valve or excessive rocking during the cardiac cycle is thought to preclude percutaneous paravalvular leak closure. However, surgical repair of paravalvular leak is associated with recurrent dehiscence and poor outcomes. We present the case of a symptomatic 74-year-old man in whom we performed percutaneous anchoring, involving multiple plugs and multimodal imaging, to stabilize a rocking mitral valve and close a substantial paravalvular leak caused by dehiscence. To our knowledge, using this technique to correct both conditions is novel.

Transapical mitral valve-in-valve implantation in patients with degenerated bioprostheses and high surgical risk

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
M Seiffert ◽  
L Conradi ◽  
S Baldus ◽  
J Schirmer ◽  
M Knap ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Valve In Valve ◽  
Valve Implantation

scholarly journals Acute and Short-Term Outcomes of Percutaneous Transcatheter Mitral Valve Replacement in Children

2021 ◽  
Author(s):  
Nicola Maschietto ◽  
Ashwin Prakash ◽  
Pedro del Nido ◽  
Diego Porras
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Pediatric Patients ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Surgical Risk ◽  
Transcatheter Mitral Valve Replacement ◽  
High Surgical Risk ◽  
Valve In Valve

Background: Despite the improvement of surgical techniques for mitral valve (MV) repair in children, mitral valve replacement (MVR) is sometimes still necessary. MVR and redo-MVR continue to be burdened by early postoperative mortality and long-term morbidity with only about 75% of these patients being alive or transplant-free 10 years after the initial MVR. Although transcatheter MVR (TMVR) is a well-established intervention in high surgical risk adults, only a few pediatric valve-in-valve case reports have been published. The purpose of this study was to describe our initial experience with the off-label use of the Sapien S3 valve for TMVR in a highly selected pediatric patient population. Methods: We conducted a retrospective analysis of pediatric patients who underwent TMVR at Boston Children’s Hospital between October 2018 and July 2020. Results: Eight consecutive high surgical risk pediatric patients (median age, 9 years; range, 8–15) underwent TMVR (7 as valve-in-valve, 1 in a native MV). Each patient previously underwent multiple MV surgeries or MVR (median 4, range 2–5) and was highly symptomatic (Ross functional class 3 or 4). The indication for TMVR was mitral stenosis in 4 patients, regurgitation in 1, and mixed disease in 3. TMVR was successful in each patient, effectively reduced the left atrium and pulmonary hypertension ( P =0.012 and 0.043 respectively), and was carried out without significant complications. Conclusions: TMVR is an attractive alternative to MVR in high surgical risk patients. In this small series, TMVR was acutely effective and safe, with very encouraging early results.

scholarly journals Residual mitral regurgitation impact on outcomes after mitraclip therapy: five-year follow-up from the GRASP registry

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
AM Caggegi ◽  
P Capranzano ◽  
S Scandura ◽  
S Mangiafico ◽  
G Castania ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Primary Endpoint ◽  
Left Ventricular ◽  
Valve Repair ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Mitraclip Therapy

Abstract Funding Acknowledgements Type of funding sources: None. Background – Although percutaneous mitral valve repair is an attractive alternative treatment option for patients with severe mitral regurgitation (MR) at high surgical risk, residual MR is commonly observed after the procedure and little is known about its impact on outcomes after MitraClip therapy, expecially in patients with severe left ventricular (LV) impairment. Purpose – The aim of this prospective, observational study was to evaluate the impact of residual MR (MR ≤1+ vs. MR >1+) on long-term outcomes of mitral valve repair with the MitraClip System in high surgical risk patients presenting with moderate-to-severe or severe MR and with severe reduction of LV ejection fraction (EF). Methods – Patients enrolled in the prospective Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation (GRASP) with functional MR and EF ≤30% who were eligible at almost five-year follow-up were included in the present analysis.  The primary endpoint was death at 5-year follow-up.  Also echocardiographic parameters at baseline and 5-year follow-up and rehospitalization rates were assessed. Results – A total of 139 patients were included: 92 (66.2%) with post-procedural residual MR ≤1+ and 47 (33.8%) with residual MR > 1+ (41 patients with residual MR 2+, 5 with residual MR 3+, 1 with residual MR 4+).  Comparable clinical and echocardiographic baseline characteristics were observed between the two groups except for NYHA functional class IV and implanted pace-maker (more frequent in patients with residual MR >1+) and previous myocardial infarction (more frequent  in patients with residual MR ≤1+). At 5-year follow-up, no significant differences were reported in the primary endpoint (49.6% in patients with residual MR ≤ 1+ vs. 65.3% in patients with residual MR > 1+, p 0.203) and in cardiac death (37.8% in patients with residual MR ≤ 1+ vs. 42.6% in patients with residual MR > 1+, p 0.921). Cox regression analysis identified residual MR > 1+ as an independent predictor of re-hospitalization (HR 0.51, 95% CI 0.28-0.92, p =0.026). At 5-year follow-up,  a significant reduction in left ventricular end-systolic volume was  observed in patients with residual MR ≤ 1+. Conclusions – At 5-year follow no significant differences in survival emerged in patients with severe  LV dysfunction undergoing MitraClip therapy regardless residual MR. Nevertheless residual MR > 1+ emerged as an indipendent predictor of re-hospitalization.

A systematic review on the safety and efficacy of percutaneous edge-to-edge mitral valve repair with the MitraClip system for high surgical risk candidates

Heart ◽  
2013 ◽  
Vol 100 (6) ◽  
pp. 473-478 ◽  
Author(s):  
Stine Munkholm-Larsen ◽  
Benjamin Wan ◽  
David H Tian ◽  
Katherine Kearney ◽  
Mohammad Rahnavardi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Surgical Risk ◽  
Safety And Efficacy ◽  
High Surgical Risk ◽  
Mitraclip System

scholarly journals Percutaneous Edge-to-Edge Mitral Valve Repair in High-Surgical-Risk Patients

2012 ◽  
Vol 5 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Ben J.L. Van den Branden ◽  
Martin J. Swaans ◽  
Martijn C. Post ◽  
Benno J.W.M. Rensing ◽  
Frank D. Eefting ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Risk Patients

A Systematic Review on Safety and Efficacy of Percutaneous Edge-To-Edge Mitral Valve Repair with the MitraClip System for High Surgical Risk Candidates

2014 ◽  
Vol 23 (1) ◽  
pp. e61-e62
Author(s):  
Benjamin Wan ◽  
Stine Munkholm-Larsen ◽  
David H. Tian ◽  
Katherine Kearney ◽  
Mohammad Rahnavardi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Surgical Risk ◽  
Safety And Efficacy ◽  
High Surgical Risk ◽  
Mitraclip System

scholarly journals Case report of simultaneous transcatheter mitral valve-in-valve implantation and percutaneous closure of two paravalvular leaks

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Masahiko Asami ◽  
Thomas Pilgrim ◽  
Stephan Windecker ◽  
Fabien Praz
Keyword(s):  
Mitral Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Transoesophageal Echocardiography ◽  
Paravalvular Leak ◽  
Open Heart ◽  
Surgical Risk ◽  
Significant Difference ◽  
Valve In Valve ◽  
Valve Implantation

Abstract Background Concomitant structural degeneration of surgical mitral bioprostheses and paravalvular leak (PVL) is rare but potentially fatal. Data pertaining to simultaneous transcatheter mitral valve implantation (TMVI) and percutaneous PVL closure are limited, and the optimal treatment strategy remains undetermined. We report a case of simultaneous TMVI and double percutaneous PVL closure in a patient with a degenerated bioprosthetic mitral valve and associated medial and lateral PVLs. Case summary A 75-year-old woman who underwent combined aortic (Edwards Perimount Magna 19 mm) and mitral (Edwards Perimount Magna 25 mm) surgical valve replacement 6 years ago was referred for treatment of new-onset orthopnoea and severely reduced exercise capacity. Transoesophageal echocardiography revealed severe mitral stenosis and concomitant moderate to severe mitral regurgitation, originating from two PVLs located medial and lateral from the surgical bioprosthesis. Due to high surgical risk, we performed successful transseptal mitral valve-in-valve (ViV) implantation combined with the closure of two PVLs during the same procedure. Discussion Although surgery should be considered as a first-line treatment in this setting, most patients have extremely high or prohibitive surgical risk inherent to repeat open heart surgery. Mitral ViV implantation appears a reasonable treatment option for patients with failed mitral bioprostheses. Furthermore, a recent study of percutaneous PVL closure showed no significant difference in long-term all-cause mortality compared with redo open-heart surgery. Simultaneous TMVI and percutaneous PVL closure appears feasible in selected high-risk patients.

Sign in / Sign up

Export Citation Format

Share Document