Progress in Mitral Valve Disease: Understanding the Revolution

Augoustides, John; Atluri, Pavan

doi:10.1053/j.jvca.2009.08.007

Cited by 14 publications

(4 citation statements)

References 62 publications

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“…Significant mitral regurgitation is one of the most common forms of valvular heart disease; its incidence increases sharply with age (1,2). In the United States, the number of patients is 6.4% in adults aged 65 to 74 years and increases to 9.3% in adults over 75 years of age (3).…”

Section: Introductionmentioning

confidence: 99%

Mitral valved stent implantation: An overview

Attmann

Pokorny

Lozonschi

et al. 2011

Minimally Invasive Therapy & Allied Technologies

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To date, transcatheter valve implantation is limited to the replacement of pulmonary and aortic valves. The aim of this study was to analyze a valved stent for minimally invasive implantation in the mitral position. A self-expanding mitral valved stent was designed for transapical implantation. Thirty pigs underwent off-pump mitral valved stent implantation with follow-up times of 60 minutes (n = 17) and seven days (n = 13). Transesophageal echocardiography and computed tomography were used to evaluate stent function and positioning. After valved stent deployment, accurate adjustment of the intra-annular position reduced paravalvular leakage in all animals. Accurate positioning was established in all but five animals. The average mean transvalvular gradient across the mitral valve and the left ventricular outflow tract recorded immediately after deployment, six hours and one week were 1.85 ± 0.95 mmHg, 3.45 ± 1.65 mmHg, 4.15 ± 2.3 mmHg and 1.35 ± 1.35 mmHg, 1.45 ± 0.7 mmHg, 1.9 ± 0.65 mmHg, respectively. No valved stent migration, embolization, systolic anterior movement or left ventricular outflow tract obstruction was observed. The mitral valved stent can be deployed in a reproducible manner to achieve reliable stent stability, minimal gradients across the left ventricular outflow tract and adequate stent function in acute and short term experimental settings.

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Section: Introductionmentioning

confidence: 99%

Mitral valved stent implantation: An overview

Attmann

Pokorny

Lozonschi

et al. 2011

Minimally Invasive Therapy & Allied Technologies

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“…[21][22][23] A classification of these technologies on the basis of anatomic targets has been proposed as follows: (1) leaflet interventions: ablation, plication, and coaptation; (2) annular interventions: direct annuloplasty, and indirect annuloplasty via the coronary sinus; and (3) chordal interventions: implantation of neochords. [21][22][23] In this family of devices, the MitraClip system (Abbott, Santa Clara, CA) reduces mitral regurgitation through precise applications of leaflet clip(s) to improve leaflet coaptation with edge-to-edge repair. 24 The conduct of this procedure has been reviewed in a stepwise fashion in the journal with a focus on intraoperative imaging guidance with transesophageal echocardiography.…”

Section: Transcatheter Mitral Valve Repairmentioning

confidence: 99%

“…[31][32][33] In concert with the momentum in transcatheter interventions for the mitral leaflet, the progress continues with transcatheter options for mitral annuloplasty, whether direct or indirect. [21][22][23] The Cardioband system (Edwards Lifesciences, Irvine, CA) is a transcatheter direct annuloplasty device that is delivers to the posterior mitral annulus via in a transvenous and then transseptal fashion. 34 The device is positioned and tightened with 3-dimensionsal transesophageal imaging guidance.…”

Section: Transcatheter Mitral Valve Repairmentioning

confidence: 99%

The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2019

Evans¹,

Weiner

Shaefi

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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This highlights in our specialty for 2019 begin with the ongoing major developments in transcatheter valve interventions. Thereafter, the advances in left ventricular assist devices are reviewed. The recent focus on conduit selection and robotic options in coronary artery bypass surgery are then explored. Finally, this special articles closes with a discussion of pulmonary hypertension in noncardiac surgery, anesthetic technique in cardiac surgery, as well as postoperative pneumonia and its outcome consequences.

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“…Moreover, despite longer cross-clamp and bypass times, mitral valve repair via videoassisted minimally invasive right thoracotomy is associated with shorter time to extubation, less postoperative bleeding, decreased need for blood transfusion, diminished pain and more rapid recovery, as evidenced by shorter hospitalization [23][24][25][26]. Additionally, in patients with prior sternotomy, this approach affords a safe exposure to the mitral valve without having to encounter the dense scar that may result from prior sternotomy [27,28].…”

Section: Minimally Invasive Mitral Valve Surgery: Right Mini-thoracotomymentioning

confidence: 99%

Minimally invasive robotic mitral valve surgery

Atluri

Woo

2011

Expert Review of Medical Devices

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Over the past two decades, significant advances have been made in mitral valve surgery. Cardiac surgeons have successfully repaired degenerative and ischemic regurgitant mitral valves via a traditional midline sternotomy. In recent years, alternate incisions have yielded minimally invasive approaches to the mitral valve. Technological advances have made robotically assisted minimally invasive mitral valve surgery feasible. Decreased pain, more rapid return to work, diminished blood loss and reduced length of hospitalization have been witnessed following robotic mitral valve surgery when compared with a traditional sternotomy. Equivalent long-term mortality and freedom from recurrent mitral regurgitation are evident between mitral valve repair performed via a traditional sternotomy and minimally invasive and robotic techniques. As a result, an increasing number of patients and referring cardiologists are seeking minimally invasive approaches to mitral valve surgery.

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Progress in Mitral Valve Disease: Understanding the Revolution

Cited by 14 publications

References 62 publications

Mitral valved stent implantation: An overview

Mitral valved stent implantation: An overview

The Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2019

Minimally invasive robotic mitral valve surgery

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