New expandable mitral annuloplasty ring facilitates transcatheter mitral valve implantation: proof of concept

2016 ◽  
Vol 11 (14) ◽  
pp. E1662-E1668 ◽  
Author(s):  
Georg D. Duerr ◽  
Jan-Malte Sinning ◽  
Fritz Mellert
Keyword(s):  
Mitral Valve ◽  
Proof Of Concept ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Valve Implantation

scholarly journals Successful mitral valve-in-ring repair of mitral annuloplasty ring dehiscence causing severe mitral regurgitation—a case report

2021 ◽  
Author(s):  
Harish Sharma ◽  
Adnan Nadir ◽  
Richard P Steeds ◽  
Sagar N Doshi
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Transesophageal Echocardiography ◽  
Severe Mitral Regurgitation ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Case Summary ◽  
Valve Implantation ◽  
Two Jets

Abstract Background Annuloplasty failure caused by ring dehiscence can lead to trans-ring and para-ring mitral regurgitation. Transcatheter treatments are available for patients at prohibitive risk of surgery. In patients unsuitable for edge-to-edge repair, valve-in-ring transcatheter mitral valve implantation has been described to treat trans-ring or para-ring jets but not both concurrently. Case summary A 78-year-old male presented with severe mitral regurgitation due to dehiscence of a 34 mm Edwards Physio II mitral annuloplasty ring. Transesophageal echocardiography showed two jets of regurgitation; trans-ring and para- ring. Repair was successfully undertaken with a valve-in-ring procedure (29 mm S3 Edwards Lifesciences). Discussion Patients with failure of mitral valve annuloplasty with trans-ring and para-ring regurgitation can be safely and effectively treated by valve-in-ring transcatheter mitral valve implantation.

scholarly journals Reduction of Para-Ring Regurgitation After Transcatheter Mitral Valve Replacement Into a Failed Mitral Annuloplasty Ring

2018 ◽  
Vol 11 (3) ◽  
pp. e17-e20 ◽  
Author(s):  
Konstantinos Toutouzas ◽  
Vasilis Lozos ◽  
George Oikonomou ◽  
Constantina Aggeli ◽  
George Latsios ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Transcatheter Mitral Valve Replacement

Medtentia Double Helix Mitral Annuloplasty System Evaluated in a Porcine Experimental Model

2010 ◽  
Vol 5 (2) ◽  
pp. 114-117 ◽  
Author(s):  
Henrik Jensen ◽  
Jarmo Simpanen ◽  
Morten Smerup ◽  
Marianne Bjerre ◽  
Morten Bramsen ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Experimental Model ◽  
Double Helix ◽  
Operating Time ◽  
Left Ventricular ◽  
Annuloplasty Ring ◽  
Invasive Approach ◽  
Mitral Annuloplasty ◽  
Midline Sternotomy

Objective To further develop and improve minimally invasive surgical procedures, dedicated appropriate surgical devices are mandatory. In this study, the safety and feasibility of implanting the novel Medtentia double helix mitral annuloplasty ring, which uses the key-ring principle to potentially allow faster and sutureless implantation, was assessed using both minimally invasive and conventional surgical techniques. Because of ethical concerns, a human compatible porcine experimental model of mitral valve surgery was used. Methods Twelve 50-kg pigs were allocated to implantation of the Medtentia double helix annuloplasty ring using conventional midline sternotomy including cardioplegic arrest or a minimally invasive approach using peripheral cannulation and left ventricular fibrillation. Ten weeks after surgery, echocardiography was performed to assess mitral valve function. Animals were then killed, and gross mitral valve anatomy was examined ex vivo. Results All animals survived 10 weeks without developing mitral regurgitation, structural leaflet damage, ring dehiscence, or endocarditis. In the minimally invasive compared with the midline sternotomy group (mean ± SD), significantly reduced recovery time (80 ± 16vs. 327 ± 23 minutes, P < 0.01) and a tendency toward increased operating time (199 ± 33 vs. 168 ± 15 minutes, P > 0.05) and cardiopulmonary bypass time (98 ± 12 vs. 91 ± 11 minutes, P > 0.05) were observed. Conclusions By using a both minimally invasive and conventional midline sternotomy implantation techniques, the Medtentia double helix annuloplasty ring showed no mitral valve dysfunction or tissue damage 10 weeks postoperatively.

scholarly journals New Mitral Annuloplasty Ring Enables Oversizing of Transcatheter Heart Valve and Prevents Central or Paravalvular Leakage

2017 ◽  
Vol 65 (06) ◽  
pp. 460-466
Author(s):  
Jan-Malte Sinning ◽  
Armin Welz ◽  
Fritz Mellert ◽  
Georg Duerr
Keyword(s):  
Mitral Regurgitation ◽  
Heart Valve ◽  
Proof Of Concept ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Concept Study ◽  
Paravalvular Leakage ◽  
Potential Source ◽  
Transcatheter Heart Valve ◽  
Transcatheter Valve

Background Transcatheter valve-in-ring strategies have been developed to treat recurrent mitral regurgitation (MR) after failing surgical annuloplasty. However, suboptimal THV expansion with consecutive paravalvular leakage (PVL) is a procedure-immanent issue. Methods A rigid, saddle-shaped ring was cut at four locations. The segments were reconnected with pull-springs, rearranged to the original shape, and covered with a sewing cuff. The length of the annuloplasty ring construct, including extended pull-springs, was defined by the perimeter of an appropriate THV. We deployed a Sapien XT within the new ring, expanded it to its maximum extent, and investigated the geometrical changes. Results Fluoroscopy confirmed oval, saddle-shaped ring before dilation. After THV implantation, the ring segments spread apart and pull-springs were stretched. The extended ring changed its configuration from “oval” to “round” and anchored the THV leaving no paravalvular or central gaps as potential source for PVL. Conclusion We developed an expandable annuloplasty ring that is perfectly concerted to THV implantation. This proof-of-concept study revealed no PVL and good oversizing ability that might impact future annuloplasty ring design. Further studies have to evaluate durability and device safety.

scholarly journals Early Period Mitral Stenosis After Mitral Annuloplasty: Functional or Real Stenosis?

2021 ◽  
Author(s):  
Serkan Asil ◽  
Veysel Özgür Barış ◽  
Suat Görmel ◽  
Murat Çelik ◽  
Uygar Çağdaş Yüksel
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Mitral Stenosis ◽  
Early Period ◽  
Valve Repair ◽  
Mitral Valve Leaflet ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty

Abstract Background:Surgical repair of rheumatic mitral valve disease is technically more demanding however, mitral repair is preferred over mechanical valve implantation if possible. İn this case report we presented the case of functional mitral stenosis after surgical mitral valve repair and annuloplasty ring implantation for rheumatic mitral regurgitation. Case Report:A 64-year-old female patient was admitted to our clinic with progressively worsening shortness of breath (New York Heart Association-Classification II-III), 6 months after surgical mitral valve repair and annuloplasty ring implantation for rheumatic mitral regurgitation. The 28/13 mmHg gradient was observed in the mitral valve annuloplasty ring in transthoracic echocardiography. TEE findings showed that motions of the mitral valve leaflet were fine, but in the mitral annuloplasty ring there was an extreme constriction and increased gradient.Conclusion:The development of mitral stenosis following mitral valve surgery is a condition associated with multiple mechanisms that are poorly understood. Mitral valve repair can be difficult and low success rate, especially in rheumatic mitral valve patients. The defect in the surgical technique and the application of restrictive small annuloplasty causes an increased gradient, leading to the development of severe functional mitral stenosis, especially when accompanied by a slight increase in pannus tissue.

Mitral Valve Insufficiency: Suspension of the Posterior Leaflet to the Mitral Annuloplasty Ring

2008 ◽  
Vol 85 (2) ◽  
pp. e6-e8 ◽  
Author(s):  
Jorge Sierra ◽  
Nadia H. Lahlaïdi ◽  
Jan T. Christenson ◽  
Afksendiyos Kalangos
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Insufficiency ◽  
Posterior Leaflet ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Valve Insufficiency

Use of Pledgeted Sutures in Mitral Annuloplasty

2014 ◽  
Vol 9 (2) ◽  
pp. 148-149
Author(s):  
Mohammed Hassan ◽  
Jimmy Windsor ◽  
Tomas Salerno ◽  
Marco Ricci
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Suture Placement

Annuloplasty ring or band dehiscence is a possible complication of mitral valve repair surgery. It may be due to increased tension on the annuloplasty sutures, especially in ischemic mitral pathology in which a circumferential ring is used. Herein, we describe a technique for alternative suture placement in mitral annuloplasty using pledgeted sutures that may reduce the risk for ring or band dehiscence.

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