The first two cases of transcatheter mitral valve repair with ARTO system in Asia

Abstract

BACKGROUND: MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and effi cacy of the ARTO system. We here report the fi rst two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia. METHODS: Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively. RESULTS: Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved. CONCLUSION: The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial.

The Prevalence and Characteristics of Mitral Regurgitation in Heart Failure: A Chart Review Study

“…Both guideline-directed medicine therapy (GDMT) and transcatheter mitral valve repair have been shown to slow the progression of MR. A randomized trial of transcatheter mitral valve repair showed that 10.61% of HF patients in the control group receiving recommended medication therapy for one year had a recovered MR in the prospective study; by contrast, the device group had a higher proportion (37.42%) [ 22 ]. Similar results were observed in Chinese patients [ 21 ]. We then examined the characteristics and risk factors for MR in greater detail.…”

“…To begin, a significant proportion of HF patients in our study had MR, particularly the HFrEF patients. Due to the high prevalence of HF in China, a significant proportion of MR patients have a poor prognosis and may benefit from mitral valve repair, as clinical trials continue [ 20 , 21 ]. Second, MR is associated with deteriorated cardiac function, including atrial and ventricle abnormalities.…”

Small balloon strategy associated with low pacemaker implantation rate after self-expanding transcatheter valve implantation

“…[15,16] The new PPMI rate in this study was lower (9.6%), which was also lower than in the Chinese Venus A analysis (18.8%). [17] In this study, the 18-mm balloon during BAV was used in 60.6% of patients. This indicates that the balloon size during BAV in our cohort was generally smaller than that in other studies.…”