Mitral Transcatheter Technologies

Abstract

Mitral valve regurgitation (MR) is often diagnosed in patients with heart failure and is associated with worsening of symptoms and reduced survival. While surgery remains the gold standard treatment in low-risk patients with degenerative MR, in high-risk patients and in those with functional MR, transcatheter procedures are emerging as an alternative therapeutic option. MitraClip® is the device with which the largest clinical experience has been gained to date, as it offers sustained clinical benefit in selected patients. Further to MitraClip implantation, several additional approaches are developing, to better match with the extreme variability of mitral valve disease. Not only repair is evolving, initial steps towards percutaneous mitral valve implantation have already been undertaken, and initial clinical experience has just started.

The Evolution of Cardiovascular Surgery in Elderly Patient: A Review of Current Options and Outcomes

“…These modalities include placing devices into the coronary sinus to support the mitral annulus and direct percutaneous leaflet repair [110, 111]. These approaches are attractive for older patients and could be treatments available to many patients with prohibitive risk with the current options.…”

Three-Dimensional Model of Left Chambers of the Heart Based on Echocardiography Data: An Instrument for Development of Transcatheter Valves

“…Это стимулирует интерес к расширению сферы применения малоинвазивного транскатетерного подхода на пациентов с патологией митрального клапана, в особенности, ишемического генеза. Именно среди данной категории больных наиболее велика доля тех, у кого стандартное открытое вмешательство сопряжено с крайне высоким риском осложнений и летальности в силу пожилого и старческого возраста, обремененного сопутствующими заболеваниями [3]. Однако анатомо-функциональные особенности митральной позиции налагают существенные ограничения как на конфигурацию транскатетерных протезов, так и на рентген-хирургический доступ к зоне имплантации.…”

Advances in Cardiac Surgery and Therapeutics

“…The MitraClip system consists of two components: the clip delivery system and the steerable guide catheter [23,24]. The clip delivery system consists of three major components: the delivery catheter, the steerable sleeve, and the MitraClip device.…”

“…A different approach to transcatheterly repair leaflet is off-pump adjustable chordal implantation, based on which several devices are currently under development, for example, the Babic device (Uros Babic, MD), the MitraFlex (TransCardiac Therapeutics, Atlanta, GA, USA), the NeoChord (NeoChord, Inc., Minnetonka, USA) and The V-Chordal (Valtech Cardio Ltd, Or-Yehuda, Israel) [26].…”

“…The Percu-Pro (Cardiosolutions, Stoughton, USA) is a space-occupying buoy anchored at the LV apex through a transseptal approach that should fill the gap between leaflets. The Thermocool irrigation ablation electrode (Biosense Webster, Inc., Diamond Bar, CA, USA) delivers, in the context of degenerative disease, radiofrequency energy to the leaflets to provoke shrinking and reduced motion [26].…”