scholarly journals Multimodality Cardiac Imaging for Procedural Planning and Guidance of Transcatheter Mitral Valve Replacement and Mitral Paravalvular Leak Closure

2021 ◽  
Vol 8 ◽  
Author(s):  
Enrique Garcia-Sayan ◽  
Tiffany Chen ◽  
Omar K. Khalique
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Cardiac Imaging ◽  
Mitral Annulus ◽  
Fusion Imaging ◽  
Paravalvular Leak ◽  
Transcatheter Mitral Valve Replacement ◽  
Transcatheter Valve ◽  
Procedural Planning

Transcatheter mitral valve interventions are an evolving and growing field in which multimodality cardiac imaging is essential for diagnosis, procedural planning, and intraprocedural guidance. Currently, transcatheter mitral valve-in-valve with a balloon-expandable valve is the only form of transcatheter mitral valve replacement (TMVR) approved by the FDA, but valve-in-ring and valve-in-mitral annular calcification interventions are increasingly being performed. Additionally, there are several devices under investigation for implantation in a native annulus. Paravalvular leak (PVL) is a known complication of surgical or transcatheter valve implantation, where regurgitant flow occurs between the prosthetic sewing ring and the native mitral annulus. We sought to describe the role and applications of multimodality cardiac imaging for TMVR, and PVL closure, including the use of Cardiovascular Computed Tomography Angiography and 3-Dimensional Transesophageal Echocardiography for diagnosis, prosthetic valve evaluation, pre-procedural planning, and intraprocedural guidance, as well as evolving technologies such as fusion imaging and 3D printing.

scholarly journals Tip-to-Base LAMPOON for Transcatheter Mitral Valve Replacement With a Protected Mitral Annulus

2021 ◽  
Vol 14 (5) ◽  
pp. 541-550 ◽  
Author(s):  
John C. Lisko ◽  
Vasilis C. Babaliaros ◽  
Jaffar M. Khan ◽  
Norihiko Kamioka ◽  
Patrick T. Gleason ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Annulus ◽  
Transcatheter Mitral Valve Replacement

New Stent for Transapical Mitral Valve Replacement in Acute Swine Experiment

2020 ◽  
Author(s):  
Yu Zou ◽  
Peng Teng ◽  
Liang Ma
Keyword(s):  
Mitral Valve ◽  
Pressure Gradient ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Annulus ◽  
The Self ◽  
Purse String ◽  
Transcatheter Mitral Valve Replacement ◽  
Before And After ◽  
The Mean

Abstract Background: Many patients with mitral regurgitation are denied open-heart surgery due to high risk. Transcatheter mitral valve replacement offers an alternative treatment. This study aimed to test the feasibility of a new self-expanding valved stent for transcatheter mitral valve replacement via apex in an acute animal model.Methods: Eight porcine experiments were performed in the acute study. A left thoracotomy was performed. The new self-expanding transcatheter valved stent was deployed under fluoroscopic guidance within the native mitral annulus via apex. Hemodynamic data, before and after implantation, were recorded. Mitral annulus diameter and valve area were measured using echocardiography. Transvalvular and left ventricular outflow tract pressure gradient were measured invasively. Results: Seven animals underwent successful transapical mitral valve replacement; the implantation was unsuccessful in one animal. The mean procedure time, defined from placing the purse-string to tightening the purse-string, was 17.14 ± 7.86 min. Hemodynamic data before and after transapical mitral valve replacement showed no difference in statistical analysis. The mean diameter and mean functional area of the self-expanding device after implantation were 2.58 ± 1.04 cm and 2.70 ± 0.26 cm2, respectively. Trace to mild central and paravalvular leak was detected in 7 valves. Mean pressure gradient across the self-expanding device was 2.00 ± 0.82 mm Hg; the corresponding gradients across the LVOT were 3.28± 1.11 mm Hg. Postmortem examinations confirmed precise device positioning in 7 animals with no signs of LVOT obstruction.Conclusion: Transcatheter mitral replacement of the new valved stent was confirmed feasible in acute preclinical models. The new stent reveals optimal design parameters.

scholarly journals A tensed Tendyne

2020 ◽  
Vol 58 (3) ◽  
pp. 651-653 ◽  
Author(s):  
Daniel Grinberg ◽  
Matteo Pozzi ◽  
Chloé Bernard ◽  
Jean-Francois Obadia
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Paravalvular Leak ◽  
Main Challenge ◽  
Low Profile ◽  
Transcatheter Mitral Valve Replacement ◽  
Left Ventricular Outflow

Abstract We report a case of prosthesis dislodgement after transcatheter mitral valve replacement in an 85-year-old woman with chronic ischaemic heart failure. Two weeks after an initial successful implantation, she presented with a paravalvular leak associated with left ventricular outflow tract obstruction. Tether re-tensioning was performed and resolved the situation, but resulted in a deformation of the apical attachment zone into the left ventricle. Unfortunately, the patient finally expired from severe endocarditis. Proper anchoring is the main challenge for transcatheter mitral valve replacement techniques. Dislodgement of the prosthesis after transcatheter mitral valve replacement is an infrequent complication of the Tendyne® procedure. This case emphasizes the importance of assessing the quality of the myocardium at the implantation zone of the apical pad, and of prosthesis oversizing, especially if low-profile valves are chosen. .

scholarly journals Transcatheter Mitral Valve Replacement: Evolution and Future Development

2021 ◽  
Author(s):  
Lina Ya’qoub ◽  
Marvin Eng
Keyword(s):  
Computed Tomography ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Future Research ◽  
Early Outcome ◽  
Transcatheter Mitral Valve Replacement ◽  
Valve In Valve ◽  
Procedural Planning ◽  
Annular Calcification

We will review transcatheter mitral valve replacement (TMVR) and discuss this evolving cutting edge procedure in terms of types (valve in valve, valve in ring and valve in mitral annular calcification MAC), clinical indications, pre-procedural planning and value of pre-procedural imaging including computed tomography role, technical challenges encountered in these procedures, potential complications for each type of TMVR, and potential strategies to mitigate and avoid such complications, We will review the currently available devices dedicated for mitral valve replacement, with a summary of their preliminary data and early outcome results. We will also discuss knowledge gaps and ideas for future research.

Predicting paravalvular leak after transcatheter mitral valve replacement using commercially available software modeling

2020 ◽  
Vol 14 (6) ◽  
pp. 495-499 ◽  
Author(s):  
Michael F. Morris ◽  
Alejandro Pena ◽  
Aneesh Kalya ◽  
Abhishek C. Sawant ◽  
Kapildeo Lotun ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Paravalvular Leak ◽  
Software Modeling ◽  
Transcatheter Mitral Valve Replacement

scholarly journals Tableside Skirt Modification of the SAPIEN 3 Valve to Reduce Paravalvular Leak During Transcatheter Mitral Valve Replacement

2021 ◽  
Vol 14 (8) ◽  
pp. 932-934
Author(s):  
Adam B. Greenbaum ◽  
Emily Perdoncin ◽  
Gaetano Paone ◽  
Kendra J. Grubb ◽  
Joe X. Xie ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Paravalvular Leak ◽  
Transcatheter Mitral Valve Replacement ◽  
Sapien 3
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