scholarly journals Multimodality imaging assessment of mitral valve anatomy in planning for mitral valve repair in secondary mitral regurgitation

2017 ◽  
Vol 9 (S7) ◽  
pp. S640-S660 ◽  
Author(s):  
Romain Capoulade ◽  
Nicolas Piriou ◽  
Jean-Michel Serfaty ◽  
Thierry Le Tourneau
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Multimodality Imaging ◽  
Valve Repair ◽  
Secondary Mitral Regurgitation

Minimally Invasive Mitral Valve Repair for Standalone Secondary Mitral Regurgitation

2020 ◽  
Author(s):  
Marco Moscarelli ◽  
Nicola Di Bari ◽  
Khalil Fattouch ◽  
Mario Siro Brigiani ◽  
Raffaele Bonifazi ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Secondary Mitral Regurgitation

Impact of disproportionate secondary mitral regurgitation in patients undergoing edge-to-edge percutaneous mitral valve repair

2020 ◽  
Vol 16 (5) ◽  
pp. 413-420 ◽  
Author(s):  
Marianna Adamo ◽  
Dario S. Cani ◽  
Mara Gavazzoni ◽  
Maurizio Taramasso ◽  
Laura Lupi ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Percutaneous Mitral Valve Repair ◽  
Secondary Mitral Regurgitation

scholarly journals Transcatheter Mitral Edge-to-Edge Repair in Patients with Primary or Secondary Mitral Regurgitation

2021 ◽  
Vol 1 (10) ◽  
Author(s):  
Kwakye Peprah ◽  
Holly Gunn ◽  
Melissa Walter
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Pacemaker Implantation ◽  
Vascular Complications ◽  
Kidney Injury ◽  
Clinical Effectiveness ◽  
Valve Repair ◽  
Significant Difference ◽  
Secondary Mitral Regurgitation

Four systematic reviews (SRs) and 6 retrospective cohort studies provided evidence for the clinical effectiveness of transcatheter mitral valve repair (TMVR) versus open heart conventional surgical mitral valve repair or replacement (SMVR) in patients with primary or secondary mitral regurgitation (MR). No relevant evidence regarding the cost-effectiveness of TMVR versus SMVR in patients with primary or secondary MR was identified; therefore, no summary can be provided. There was evidence indicating a statistically significant difference in favour of TMVR over SMVR regarding the odds of post-procedure bleeding, need for permanent pacemaker implantation, 30-day readmission, and a shorter duration of hospitalization. There was evidence suggesting a statistically significant difference in favour of SMVR over TMVR regarding the odds of recurrent MR, the need for reoperation, and mortality rate (i.e., during hospitalization, at 1 year, and > 3 years). Also, compared with TMVR, the likelihood of residual MR grade > 2 or freedom from MR grade ≥ 2 or ≥ 3 at 4 years was statistically significantly lower or higher, respectively, with SMVR. Evidence regarding the comparative clinical effectiveness of TMVR versus SMVR concerning stroke, acute kidney injury (AKI), cardiogenic shock, and death during hospitalization was conflicting and inconclusive. There was no evidence of a significant difference between the 2 interventions regarding overall mortality or mortality at 5 years, overall survival, freedom from cardiac death at 4 years, cardiac arrest, acute myocardial infarction (MI), and respiratory or vascular complications. A major limitation of the evidence was that it derives from studies of low or unknown quality and risk of bias, Furthermore, all the findings are confounded by differences in patient selection, which reflect the approved indications for the interventions but prevent a direct comparison between the TMVR and SMVR groups.

scholarly journals Asymmetric leaflet tethering is associated with worse outcomes after edge-to-edge mitral valve repair for secondary mitral regurgitation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L Stolz ◽  
M Orban ◽  
D Braun ◽  
P Doldi ◽  
M Orban ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Cox Regression ◽  
Cox Model ◽  
Operating Characteristics ◽  
Valve Repair ◽  
Cox Regression Analysis ◽  
Secondary Mitral Regurgitation ◽  
The Impact

Abstract Background The impact of mitral valve (MV) tethering patterns on outcomes of patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) for severe secondary mitral regurgitation (SMR) is unknown. Purpose The purpose of this study was to evaluate the impact of asymmetric postero-anterior and medio-lateral MV leaflet tethering on procedural and survival outcomes after TEER for SMR. Methods Symmetry of postero-anterior leaflet tethering was defined as the ratio of the posterior to anterior MV leaflet angle (PLA/ALA) in the central MV segment 2. The ratio of the tenting area between MV segments 3 and 1 (S3/S1 ratio) was defined as medio-lateral tethering symmetry. We used receiver operating characteristics and a proportional Cox model to identify cut-off values of asymmetric postero-anterior and medio-lateral tethering for prediction of two-year survival after TEER. Results 178 patients receiving TEER for SMR were included. Asymmetric postero-anterior tethering was observed in 67 patients (37.6%, PLA/ALA ratio cut-off >1.54). Medio-lateral tethering was asymmetric in 49 patients (27.5%, S3/S1 ratio cut-off >1.49). MR was reduced to MR ≤2+ in 91.6% of patients, while postprocedural MR remained higher in the presence of asymmetric postero-anterior tethering (p=0.01). After adjustment for potential clinical and echocardiographic confounders, multivariable Cox regression analysis confirmed asymmetric postero-anterior tethering (HR=2.77, CI=1.43–5.38, p<0.01) and asymmetric medio-lateral tethering (HR=2.90, CI=1.54–5.45, p<0.01) as independent predictors for two-year survival. Conclusions Asymmetric postero-anterior and medio-lateral MV leaflet tethering patterns independently increase two-year all-cause mortality in patients undergoing TEER for SMR. Detailed echocardiographic patient selection might improve outcomes after TEER. FUNDunding Acknowledgement Type of funding sources: None. Postero-anterior tethering Medio-lateral tethering

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