Transapical transcatheter mitral valve-in-valve implantation versus minimally invasive surgery for failed mitral bioprostheses†

Murzi, Michele; Berti, Sérgio; Gasbarri, Tommaso; Trianni, Giuseppe; Maffei, Stefano; Solinas, Marco; Dvir, Danny; Cerillo, Alfredo Giuseppe

doi:10.1093/icvts/ivx067

Cited by 22 publications

(22 citation statements)

References 11 publications

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Section: Resultsmentioning

confidence: 99%

“…Of 270 potentially relevant articles screened initially, 17 eligible studies including a total of 1017 patients undergoing VIV/VIR‐TMVI were identified (Table ). Only two small‐size study compared VIV‐TMVI with redo MVS, and one of them using a propensity‐score analysis . Eleven studies analyzed exclusive VIV‐TMVI patients, only one study examined exclusive VIR‐TMVI patients, two studies investigated combined VIV/VIR‐TMVI patients, and three studies researched VIV‐TMVI and VIR‐TMVI patients separately.…”

Section: Resultsmentioning

confidence: 99%

“…Only two small‐size study compared VIV‐TMVI with redo MVS, and one of them using a propensity‐score analysis . Eleven studies analyzed exclusive VIV‐TMVI patients, only one study examined exclusive VIR‐TMVI patients, two studies investigated combined VIV/VIR‐TMVI patients, and three studies researched VIV‐TMVI and VIR‐TMVI patients separately. Deteriorated bioprosthetic valves and failed annuloplasty rings were summarized in Supplementary Table S1, and implanted transcatheter heart valves and approaches in Supplementary Table S2.…”

Section: Resultsmentioning

confidence: 99%

“…Deteriorated bioprosthetic valves and failed annuloplasty rings were summarized in Supplementary Table S1, and implanted transcatheter heart valves and approaches in Supplementary Table S2. The TA approach was exclusively applied in seven studies, the TS approach was exclusively used in two studies and the VIR patients of one study, and both the approaches were utilized in seven studies . In total, the TA and TS approach was used in 40.4% and 55.5% of patients, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Transcatheter mitral valve implantation (TMVI) by the off‐label use of transcatheter aortic valve implantation (TAVI) devices has developed and refined on safe and effective management of the variety of pathologies after MVS . To the best of our knowledge, however, no randomized controlled trial (RCT) and only two small‐size comparative study of TMVI for deteriorated bioprosthetic valves (valve‐in‐valve [VIV]‐TMVI) and/or failed annuloplasty rings (valve‐in‐ring [VIR]‐TMVI) versus redo MVS have been conducted to date. Thus, it remains unclear whether VIV/VIR‐TMVI reduces mortality as compared with redo MVS.…”

Section: Introductionmentioning

confidence: 99%

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A meta‐analysis of valve‐in‐valve and valve‐in‐ring transcatheter mitral valve implantation

Takagi

Hari

Kawai

et al. 2018

J Interven Cardiology

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Objectives: We performed a meta-analysis of transcatheter mitral valve implantation (TMVI) for deteriorated bioprosthetic valves (valve-in-valve [VIV]-TMVI) and/or failed annuloplasty rings (valve-in-ring [VIR]-TMVI), comparing observed early (30-day) mortality with predicted operative mortality. Background: It remains unclear whether VIV/VIR-TMVI reduces mortality as compared with redo MVS. Methods: MEDLINE and EMBASE were searched current through 24 July 2018 using Web-based search engines (PubMed and OVID) to identify studies including ≥10 patients undergoing VIV/VIR-TMVI. For each study, data regarding observed 30-day mortality and predicted operative mortality (Society of Thoracic Surgeons Predicted Risk of Mortality [STS-PROM]) were used to generate risk ratios (RRs) and 95% confidence intervals (CIs). Study-specific estimates were combined using the inverse variance-weighted average of logarithmic RRs in the random-effects model. Onegroup meta-analyses of 30-day/late (including 30-day) mortality rates were also performed in the random-effects model.Results: Of 270 potentially relevant articles screened initially, 17 eligible studies including a total of 1017 patients undergoing VIV/VIR-TMVI were identified. In all but four studies, the STS-PROM was available and varied from 7.7% to 22.0% (weighted mean, 11.5%). Pooled analyses of all VIV/VIR-TMVI studies demonstrated the 30-day mortality rate of 5.4% (95%CI, 4.0-6.8%), the midterm (1-to 5-year) mortality rate of 13.7% (95%CI, 9.0-18.5%), and significantly lower observed 30-day mortality than predicted operative mortality (RR, 0.67; 95%CI, 0.49-0.91; P = 0.01).Conclusions: VIV/VIR-TMVI brought about relatively low early and midterm (1-to 5year) mortality, and observed 30-day mortality was significantly lower than predicted operative mortality. K E Y W O R D S meta-analysis, mortality, transcatheter mitral valve implantation, valve-in-ring, valve-in-valve J Interv Cardiol. 2018;31:899-906.wileyonlinelibrary.com/journal/joic

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A meta‐analysis of valve‐in‐valve and valve‐in‐ring transcatheter mitral valve implantation

Takagi

Hari

Kawai

et al. 2018

J Interven Cardiology

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Surgical redo versus transseptal or transapical transcatheter mitral valve‐in‐valve implantation for failed mitral valve bioprosthesis

Simonetto

Purita

Malerba

et al. 2020

Cathet Cardio Intervent

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Background Redo surgical mitral valve replacement (SMVR) is the current standard of care for patients with failed bioprosthetic mitral valve (MV). Transcatheter mitral valve‐in‐valve replacement (TMViV) is arising as an alternative to SMVR in high risk patients. We sought to evaluate procedural safety, early and mid‐term outcomes of patients who underwent transseptal TMViV (TS‐TMViV), transapical TMViV (TA‐TMViV), or redo‐SMVR. Methods We identified patients with failed bioprosthetic MV who underwent TS‐TMViV, TA‐TMViV, or SMVR at four Italian Centers. Clinical and echocardiographic data were codified according to Mitral Valve Academic Research Consortium definition (MVARC), except for significant valve stenosis. Results Between December 2012 and September 27, 2019 patients underwent TS‐TMViV, 22 TA‐TMViV, and 29 redo‐SMVR. TS‐TMViV and TA‐TMViV patients presented higher mean age and surgical risk scores compared with SMVR group (77.8 ± 12 years, 77.3 ± 7.3 years, 67.8 ± 9.4 years, p < .001; STS PROM 8.5 ± 7.2; 8.9 ± 4.7; 3.6 ± 2.6, p < .001). TS‐TMViV procedure was associated with shorter intensive care unit time and total length of stay (LOS) compared with TA‐TMViV and SMVR group. There were no differences in MVARC procedural success at 30‐days (74.1, 72.7, and 51.7%, p = .15) and one‐year all‐cause mortality between groups (14.8, 18.2, and 17.2%, p = 1.0). MV mean gradient was similar between TS‐TMViV, TA‐TMViV, and SMVR groups at 30 days and 12 months. Conclusions For the selected patients, TS‐TMViV and TA‐TMViV are to be considered a valid alternative to redo‐SMVR with comparable 1‐year survival. TS‐TMViV is the less invasive strategy and has the advantage of shortening the LOS compared with TA‐TMViV.

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Clinical Outcomes of Transcatheter Mitral Valve‐In‐Valve and Valve‐In‐Ring Implantation: A Systematic Review and Meta‐Analysis

Fong,

Koh,

Saw

et al. 2024

Cathet Cardio Intervent

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BackgroundTranscatheter valve‐in‐valve (VIV) or valve‐in‐ring (VIR) therapies for degenerated mitral bioprosthetic valves and rings are still evolving. We aimed to characterize short‐ and long‐term outcomes of these procedures.MethodsAn electronic literature search was conducted to retrieve articles describing mitral VIV or VIR implantation with at least 10 patients. Meta‐analysis of proportions was carried out for 30‐day or in‐hospital outcomes of mortality, stroke, major bleeding, transfusion, acute kidney injury, procedural success, valve embolization, paravalvular leak, pacemaker implantation, and hospital stay. Individual patient data meta‐analysis using Kaplan‐Meier curve reconstruction was used to estimate long‐term mortality of VIV, VIR and redo surgical mitral valve replacement (SMVR).ResultsWe analyzed 34 studies (7047 patients). Pooled procedural success was 94.8% in VIV and 80.5% in VIR. Pooled short‐term mortality and stroke risk was 6.4% and 1.9% respectively in VIV, 9.1% and 1.6% respectively in VIR, and 8.4% and 5.5% respectively in SMVR.ConclusionsThis study provides prognostic information on clinical outcomes for redo SMVR and transcatheter mitral VIV and VIR implantation.

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Transapical transcatheter mitral valve-in-valve implantation versus minimally invasive surgery for failed mitral bioprostheses†

Abstract: In selected patients, M-VIV can be performed safely with results comparable with those of surgical therapy.

Cited by 22 publications

References 11 publications

A meta‐analysis of valve‐in‐valve and valve‐in‐ring transcatheter mitral valve implantation

A meta‐analysis of valve‐in‐valve and valve‐in‐ring transcatheter mitral valve implantation

Surgical redo versus transseptal or transapical transcatheter mitral valve‐in‐valve implantation for failed mitral valve bioprosthesis

Clinical Outcomes of Transcatheter Mitral Valve‐In‐Valve and Valve‐In‐Ring Implantation: A Systematic Review and Meta‐Analysis

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