Hemolysis After Transcatheter Mitral Valve Implantation Resolved by Valve Retensioning

Reineke, David; Brugger, Nicolas; Wild, Mirjam G.; Mihalj, Maks; Madhkour, Raouf; Terbeck, Sandra; Eberle, Balthasar; Windecker, Stephan; Praz, Fabien

doi:10.1016/j.jaccas.2021.04.018

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…However, the risk of potential LVOTO remains a challenge and might occur despite meticulous screening. 20 In TENDER, there was one patient with LVOTO leading to became apparent in our cohort with two patients experiencing of major apical access site bleeding and ventricular rupture ultimately causing procedural death. Furthermore, this approach may lead to longer intensive care unit and hospital stay due to longer recovery time.…”

Section: Discussionmentioning

confidence: 89%

“…The availability of different valve sizes, including low‐profile valves, might overcome some anatomical limitations like too small or too large MV annulus and left ventricular dimensions. However, the risk of potential LVOTO remains a challenge and might occur despite meticulous screening 20 . In TENDER, there was one patient with LVOTO leading to haemodynamic instability and conversion to open‐heart surgery.…”

Section: Discussionmentioning

confidence: 99%

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Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real‐world multicentre experience

Wild

Kreidel

Hell

et al. 2022

European J of Heart Fail

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Aims Transcatheter mitral valve implantation (TMVI) is a new treatment option for patients with symptomatic mitral valve (MV) disease. Real‐world data have not yet been reported. This study aimed to assess procedural and 30‐day outcomes of TMVI in a real‐world patient cohort. Method and results All consecutive patients undergoing implantation of a transapically delivered self‐expanding valve at 26 European centres from January 2020 to April 2021 were included in this retrospective observational registry. Among 108 surgical high‐risk patients included (43% female, mean age 75 ± 7 years, mean STS‐PROM 7.2 ± 5.3%), 25% was treated for an off‐label indication (e.g. previous MV intervention or surgery, mitral stenosis, mitral annular calcification). Patients were highly symptomatic (New York Heart Association [NYHA] functional class III/IV in 86%) and mitral regurgitation (MR) was graded 3+/4+ in 95% (38% primary, 37% secondary, and 25% mixed aetiology). Technical success rate was 96%, and MR reduction to ≤1+ was achieved in all patients with successful implantation. There were two procedural deaths and 30‐day all‐cause mortality was 12%. At early clinical follow‐up, MR reduction was sustained and there were significant reductions of pulmonary pressure (systolic pulmonary artery pressure 52 vs. 42 mmHg, p < 0.001), and tricuspid regurgitation severity (p = 0.013). Heart failure symptoms improved significantly (73% in NYHA class I/II, p < 0.001). Procedural success rate according to MVARC criteria was 80% and was not different in patients treated for an off‐label indication (74% vs. 81% for off‐ vs. on‐label, p = 0.41). Conclusion In a real‐world patient population, TMVI has a high technical and procedural success rate with efficient and durable MR reduction and symptomatic improvement.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real‐world multicentre experience

Wild

Kreidel

Hell

et al. 2022

European J of Heart Fail

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“…Details of the procedure have been previously published as case report. 12 Ad hoc retensioning after complete delivery and detachment of the device has been used in one subsequent case to optimize valve position.…”

Section: Valve Retensioning After Tmvi Resolving Hemolysis (Case 1)mentioning

confidence: 99%

“…The patient underwent valve retensioning 11 weeks after TMVI, with resolution of symptoms and hemolysis. 12 Two patients were hospitalized with dyspnea due to deconditioning and chronic heart failure. The fourth patient was hospitalized following a syncope possibly related to intensive heart failure treatment.…”

Section: Clinical and Echocardiographic Follow-upmentioning

confidence: 99%

Transapical Transcatheter Mitral Valve Implantation with the Tendyne Valve: The Swiss Experience

Nucera

Miazza

Praz

et al. 2023

Thorac Cardiovasc Surg

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Background The aim of this study was to report outcomes of all patients undergoing transcatheter mitral valve implantation with the Tendyne Mitral Valve System (Tendyne) in Switzerland. Methods We retrospectively analyzed preoperative echocardiographic and computed tomography (CT) data, procedural findings, and 30-day and 1-year follow-up echocardiographic and clinical data of patients who underwent transcatheter mitral valve implantation with Tendyne in Switzerland. Results A total of 24 patients (age, 74.8 ± 7.8 years; 67% male) underwent transapical transcatheter mitral valve implantation with Tendyne between June 2020 and October 2022. Technical success rate was 96%. In five patients, concomitant interventions in the form of transcatheter aortic valve implantation (one patient), minimally invasive direct coronary artery bypass (one patient), and transcatheter edge-to-edge repair (three patients) were performed prior to or after the index procedure. There was one device embolization, and two patients required valve retrieval. In-hospital outcomes included one stroke and three major bleeding events. None of the patients died within 30 days. Two patients were rehospitalized for decompensated heart failure. At 1-year follow-up, there were three noncardiovascular-related deaths. Conclusion Transcatheter mitral valve implantation with Tendyne is feasible to treat polymorbid patients suffering from complex mitral valve disease as well as patients with previous mitral interventions. Perioperative risk was acceptable and procedural success high.

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The Case | Is this hemolytic uremic syndrome?

Kettritz

Düttmann

Brand

et al. 2022

Kidney International

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Hemolysis After Transcatheter Mitral Valve Implantation Resolved by Valve Retensioning

Cited by 5 publications

References 11 publications

Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real‐world multicentre experience

Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real‐world multicentre experience

Transapical Transcatheter Mitral Valve Implantation with the Tendyne Valve: The Swiss Experience

The Case | Is this hemolytic uremic syndrome?

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