Short-Term Results of Transapical Transcatheter Mitral Valve Implantation for Mitral Regurgitation

Abstract

Transapical transcatheter mitral valve implantation is technically feasible and can be performed safely. Early hemodynamic performance of the prosthesis was excellent. Transcatheter mitral valve implantation may become an important treatment option for patients with severe MR who are at high operative risk.

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

“…[1][2][3][4][5] Similar to transcatheter aortic valve implantation, determination of anatomic eligibility and valve sizing is contingent on preprocedural imaging. 6,7 It is well established that the mitral annulus (MA) contour is nonplanar and saddleshaped with 2 peaks; a posterior peak formed by the insertion of the posterior mitral valve leaflet and an anterior peak which extends to the level of the aortic valve and annulus.…”

First-in-Human Case of Transfemoral CardiAQ Mitral Valve Implantation

“…Interestingly, these challenges have been addressed in different ways, for example, by introducing a D-shaped stent design, annular versus apical anchoring, or a large inflow sealing area. [1][2][3][4] Also the CardiAQ prosthesis has been optimized since its first implant, as described in this report. The second-generation CardiAQ valve is built on the company's proprietary method for anchoring the implant through leaflet engagement, chordal preservation, and annular attachment, while offering improved flow properties and a novel feature for the prevention of paravalvular leaks.…”

“…This study will enroll ≤20 patients and will involve both the transfemoral (n=10) and TA (n=10) TMVI systems. Also Neovasc Inc (Tiara valve), 2 Tendyne Inc (Tendyne valve), 3 and Edwards LifeSciences (Fortis valve) 4 performed their first-inhuman TA-TMVI procedures in 2014 and recently received Food and Drug Administration approval for early feasibility trials, indicating that the TMVI technology has reached a new stage in its development.…”

Peri-procedural imaging for transcatheter mitral valve replacement

“…Initial experience showed successful implantation in 29 of 36 swine with failure mainly due to improper positioning or failure of the valve anchors (28). Two human cases of Tiara valve implantation were performed via transapical approach in January and February 2014 in British Columbia, Canada (29). The procedures were completed without any complication and patients improved in MR and left ventricular volumes (2).…”