Mitral and Tricuspid Transcatheter Interventions Current Indications and Future Directions

Winkel, Mirjam; Praz, Fabien; Wenaweser, Peter

doi:10.3389/fcvm.2020.00061

Cited by 11 publications

(8 citation statements)

References 69 publications

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“…Repair strategies are divided into edge‐to‐edge or leaflet repair, chordal repair, and annuloplasty. Strategies and devices are summarized in Figure 1 8–10 …”

Section: Narrativementioning

confidence: 99%

Transcatheter mitral valve therapies: State of the art

Yousef

Arnaoutakis

Gada

et al. 2021

Journal of Cardiac Surgery

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Mitral regurgitation (MR) is one of the most prevalent valvular pathologies in the developed world. There continues to be a growing population of aging patients with MR who may be too high risk for surgical management. The rapid adoption and remarkable success of transcatheter aortic valve replacement (TAVR) generated enthusiasm for transcatheter mitral valve therapies; however, the complex anatomy and pathophysiology of the mitral valve confers several unique challenges for a fully percutaneous approach. Nevertheless, several devices are under development and in various phases of preclinical or clinical testing, both for transcatheter mitral valve replacement and repair. MitraClip (Abbott Vascular), which has received FDA approval, is the most established percutaneous repair strategy and has been performed in over 80,000 patients as of 2019. The following article serves as a review of the available and upcoming devices for the various etiologies of mitral valvular disease, as well as the unique challenges and potential complications of transcatheter mitral valve intervention.

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“…Repair strategies are divided into edge‐to‐edge or leaflet repair, chordal repair, and annuloplasty. Strategies and devices are summarized in Figure 1 8–10 …”

Section: Narrativementioning

confidence: 99%

Transcatheter mitral valve therapies: State of the art

Yousef

Arnaoutakis

Gada

et al. 2021

Journal of Cardiac Surgery

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“…Systematic reviews place the mortality rate anywhere between 10 to 60% after one year, while the risk of developing heart failure can be as high as 31%. 49,51,53,55 Tendyne prosthesis (Abbott Structural, Santa Clara the US) is the first TMVR device to gain CE approval in January 2020, but the evolution of TMVR systems is far from rapid, due to the strict selection criteria of ongoing clinical trials, which affect results by diminishing the external validity of the studies and their transferability to real-life clinical scenarios . 49,51 Minimally Invasive Surgery Surgical mitral valve repair is the gold standard for treating primary MR and around 95% of patients being treated in designated centres while the remaining 5% who are not suited for surgery, will be considered for one of the aforementioned transcatheter interventions.…”

Section: Transcatheter Mitral Valve Replacementmentioning

confidence: 99%

Mitral valve disease: A view on pathophysiology and management of the most common valve disease in the world

Botezatu

Kakar

Ren

et al. 2020

Preprint

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Objectives: Mitral valve disease is increasingly prevalent. Timely diagnosis and the choice of the right intervention are very important in the early stages, as valvular dysfunction often leads to cardiac failure and even sudden death. The focus of this paper is on the various pathologies of the mitral valve, their etiology, and clinical management. Methods: Mitral regurgitation (MR) can be managed surgically, percutaneously or medically. Treatment methods for primary MR include percutaneous mitral valve (MV) repair, MV replacement, minimally invasive mitral valve surgery (MIMVS), and more recently, robotics. Additionally, conventional sternotomy has been used for both MR and mitral stenosis. Nonetheless, ongoing clinical trials are a clear indicator that the management of valve diseases is continuously evolving. Results: Multiple studies favour MV repair via MIMVS, over conventional sternotomy or percutaneous approach. However, more data is needed to optimize patient selection. Robot assisted repair is a new alternative, but attention should be given to the steep learning curve and medical training of professionals wishing to perform this intervention. Cost effectiveness and possible side effects should be explored by clinical trials as well. While guidelines are fairly straightforward for primary MR, there is insufficient evidence to suggest that surgical treatment is advantageous for secondary MR. Management is usually pharmaceutical and aims to treat symptoms rather than cause. Conclusion: Mitral valve disease remains a medical challenge, but numerous research and clinical trials have been embarked upon to refine old methods and discover new ones to improve treatment success and procedural safety.

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Section: Transcatheter Treatments and The Futurementioning

confidence: 99%

“…A recent review 56 attempted to explore the current indications for transcatheter interventions in both mitral and tricuspid repair but still only yielded minimal results for the tricuspid repair compared to mitral. This highlights the limited literature and concludes that, in the coming years, transcatheter interventions will benefit an increased patient volume and thus the clinical indications can be further explored.…”

Section: Further Researchmentioning

confidence: 99%

Tricuspid valve diseases: Interventions on the forgotten heart valve

Yoganathan

Khan

et al. 2020

J Card Surg

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Over the past few decades, the tricuspid valve (TV) interventions have been relatively lower compared to other cardiac valvular disease in terms of pathophysiology and management, especially regarding surgical intervention and therapy. However, recent crucial advances in assessment and management of the TV disease have resulted in a renewed interest in the "forgotten valve." The medical treatment aims to cure the underlying disease and address the presentation of the right heart failure. Surgical interventions have proven to yield good outcomes for those for whom surgery is indicated. For those who are not suitable for surgery, transcatheter surgery may prove to be a suitable replacement. Best practice with regard to surgical techniques is still in question due to limited data. This has been slowing the introduction of transcatheter interventions into common practical guidelines. The aim of this literature review is to discuss new insights on the pathophysiology, diagnosis, and interventions of TV disease, highlighting the surgical management and emerging transcatheter therapies. In addition, this review will provide an overview of the current state of the literature surrounding TV interventions and providing suggestions for future directives.

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Mitral and Tricuspid Transcatheter Interventions Current Indications and Future Directions

Cited by 11 publications

References 69 publications

Transcatheter mitral valve therapies: State of the art

Transcatheter mitral valve therapies: State of the art

Mitral valve disease: A view on pathophysiology and management of the most common valve disease in the world

Tricuspid valve diseases: Interventions on the forgotten heart valve

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