scholarly journals Transseptal transcatheter mitral valve replacement

2020 ◽  
Vol 25 (8) ◽  
pp. 3842
Author(s):  
V. I. Ganyukov ◽  
R. S. Tarasov ◽  
I. V. Ganyukov
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Disease ◽  
Current Data ◽  
Valve Disease ◽  
Less Invasive ◽  
Transcatheter Mitral Valve Replacement

The review presents current data transseptal transcatheter mitral valve replacement, which is becoming an alternative method of managing mitral valve disease. Despite the fact that the transapical transcatheter approach is technically simpler, the transseptal method is less invasive. It has confirmed effectiveness and is predicted to be the most promising. The review describes the relevance, indications, methodology for selecting the required endoprosthesis, stages of procedure, complications, and the postoperative follow-up of patients. The results of publications on transseptal transcatheter mitral valve replacement are analyzed. A case report is given.

scholarly journals Transseptal Approach for Mitral Valve Replacement in Dextrocardia with Situs Inversus Totalis: A Case Report and Review of the Literature

2020 ◽  
Vol 23 (1) ◽  
pp. E030-E033 ◽  
Author(s):  
Ovidiu Stiru ◽  
Roxana Carmen Geana ◽  
Razvan Radu Ilie ◽  
Ovidiu Chioncel ◽  
Raluca Tulin ◽  
...  
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Situs Inversus ◽  
Mitral Valve Disease ◽  
Vena Cava ◽  
Situs Inversus Totalis ◽  
Valve Disease ◽  
Transseptal Approach

We consider mitral valve disease requiring surgery in a patient with dextrocardia and situs inversus totalis to be an exceptional finding. The transseptal approach for mitral valve surgery in dextrocardia represents a technical challenge owing to its anatomic particulars. We present the case of a 56-year-old female patient who had been diagnosed with situs inversus totalis in childhood and with chronic atrial fibrillation in adulthood and was under oral anticoagulant treatment. She was referred to our hospital for increasing dyspnea and palpitation. Transthoracic echocardiography detected severe mitral regurgitation associated with moderate tricuspid regurgitation, with normal left and right ventricular function. Contrast chest computed tomography (CT) and preoperative abdominal CT showed both dextrocardia and situs inversus totalis, with normal continuity of the inferior vena cava. Biatrial cannulation was performed with the surgeon standing on the right side of the patient, and mitral valve replacement using a transseptal approach was performed with the surgeon standing on the left side of the patient. In this case report, we emphasize the rarity of mitral valve disease in a patient with dextrocardia and the inherent potential difficulty that can appear in this particular anatomic condition.

scholarly journals Transcatheter Mitral Valve Replacement for Treating Native Mitral Valve Disease: Current Status

2020 ◽  
Vol 47 (4) ◽  
pp. 271-279
Author(s):  
Yan Chen ◽  
Junjie Hu ◽  
Shunqiang Wu ◽  
San Zhang ◽  
Kaiqin Wu ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Disease ◽  
Mitral Stenosis ◽  
Valve Disease ◽  
Technical Success Rate ◽  
Transcatheter Mitral Valve Replacement ◽  
Transapical Access

Transcatheter mitral valve replacement is increasingly being used as a treatment for high-risk patients who have native mitral valve disease; however, no comprehensive studies on its effectiveness have been reported. We therefore searched the literature for reports on patients with native mitral valve disease who underwent transcatheter access treatment. We found 40 reports, published from September 2013 through April 2017, that described the cases of 66 patients (mean age, 71 ± 12 yr; 30 women; 30 patients with mitral stenosis, 34 with mitral regurgitation, and 2 mixed) who underwent transcatheter mitral valve replacement. We documented their baseline clinical characteristics, comorbidities, diagnostic imaging results, procedural details, and postprocedural results. Access was transapical in 41 patients and transseptal in 25. The 30-day survival rate was 82.5%. The technical success rate (83.3% overall) was slightly but not significantly better in patients who had mitral regurgitation than in those who had mitral stenosis. Transapical access procedures resulted in fewer valve-in-valve implantations than did transseptal access procedures (P=0.026). These current results indicate that transcatheter mitral valve replacement is feasible in treating native mitral disease. The slightly higher technical success rate in patients who had mitral regurgitation suggests that a valve with a specific anchoring system is needed when treating mitral stenosis. Our findings indicate that transapical access is more reliable than transseptal access and that securely anchoring the valve is still challenging in transseptal access.

scholarly journals Early results of a real-world series with two transapical transcatheter mitral valve replacement devices

2020 ◽  
Author(s):  
S. Ludwig ◽  
D. Kalbacher ◽  
N. Schofer ◽  
A. Schäfer ◽  
B. Koell ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Functional Improvement ◽  
Study Cohort ◽  
Early Results ◽  
Transcatheter Mitral Valve Replacement

Abstract Aims Transcatheter mitral valve replacement (TMVR) with dedicated devices promises to fill the treatment gap between open-heart surgery and edge-to-edge repair for patients with severe mitral regurgitation (MR). We herein present a single-centre experience of a TMVR series with two transapical devices. Methods and results A total of 11 patients were treated with the Tendyne™ (N = 7) or the Tiara™ TMVR systems (N = 4) from 2016 to 2020 either as compassionate-use procedures or as commercial implants. Clinical and echocardiographic data were collected at baseline, discharge and follow-up and are presented in accordance with the Mitral Valve Academic Research Consortium (MVARC) definitions. The study cohort [age 77 years (73, 84); 27.3% male] presented with primary (N = 4), secondary (N = 5) or mixed (N = 2) MR etiology. Patients were symptomatic (all NYHA III/IV) and at high surgical risk [logEuroSCORE II 8.1% (4.0, 17.4)]. Rates of impaired RV function (72.7%), severe pulmonary hypertension (27.3%), moderate or severe tricuspid regurgitation (63.6%) and prior aortic valve replacement (63.6%) were high. Severe mitral annulus calcification was present in two patients. Technical success was achieved in all patients. In 90.9% (N = 10) MR was completely eliminated (i.e. no or trace MR). Procedural and 30-day mortality were 0.0%. At follow-up NYHA class was I/II in the majority of patients. Overall mortality after 3 and 6 months was 10.0% and 22.2%. Conclusions TMVR was performed successfully in these selected patients with complete elimination of MR in the majority of patients. Short-term mortality was low and most patients experienced persisting functional improvement. Graphic abstract

scholarly journals Retrospective Study of the Outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair in Ain Shams University

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M A Elfeky ◽  
M M A Fadala ◽  
O A Abdelhameed ◽  
R M R Khorshid
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Tricuspid Valve ◽  
Mitral Valve Disease ◽  
Valve Disease ◽  
Morbidity And Mortality ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Number Of Patients

Abstract Background Rheumatic mitral valvular disease is more common than degenerative mitral valve disease. Mitral valve repair is not possible in large number of patients because of rheumatic cicatrized subvalvular mitral valve disease. The prosthetic mitral valve replacement is commonly performed in our center. Objective The aim of the study was to evaluate and assess the short outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair. Patients and Methods This study was done in department of Cardiothoracic surgery, Faculty of Medicine at Ain Shams university, after approval of the local ethical committee from 2015 to 2016.The inclusion criteria includes All gender, All age, Primary Mitral valve replacement for severe Mitral valve disease of Rheumatic origin with or without Tricuspid Valve Repair and Primary Mitral valve replacement for severe Mitral valve disease of Degenerative origin with or without Tricuspid Valve Repair and the exclusion criteria includes concomitant coronary artery bypass graft surgery or other cardiac operations or infective endocarditis and Patients with chronic liver, kidney and parenchymal pulmonary disease. Results This study included one hundred and seventy- seven (177) patients; One hundred and thirty one (131) patients did Mitral Valve Replacement without Tricuspid valve Repair, Fourty six (46) patients did Mitral valve Replacement with Tricuspid valve Repair and the outcome was Mortality (3.9%), Reoperaion (5.08%), Stroke (0. 56%), Re-Intubation (1.13%) and Re-Admission to ICU (1.69%) Conclusion The Reoperation has a direct relation and effect on the Mortality,Prolonged bypass time independently predicts postoperative morbidity and mortality and Prolonged aortic cross-clamp time significantly correlates with major post-operative morbidity and mortality.

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