Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings

Yoon, Sung Han; Whisenant, Brian; Bleiziffer, Sabine; Delgado, Victoria; Schofer, Niklas; Eschenbach, Lena Katharina; Fujita, Buntaro; Sharma, Rahul; Ancona, Marco; Yzeiraj, Ermela; Cannata, Stefano; Barker, Colin M.; Davies, James E.; Frangieh, Antonio H.; Deuschl, Florian; Podlesnikar, Tomaž; Asami, Masahiko; Dhoble, Abhijeet; Chyou, Anthony; Masson, Jean Bernard; Wijeysundera, Harindra C.; Blackman, Daniel J.; Rampat, Rajiv; Taramasso, Maurizio; Gutiérrez‐Ibañes, Enrique; Chakravarty, Tarun; Attizzani, Guiherme; Kaneko, Tsuyoshi; Wong, S. Chiu; Sievert, Horst; Nietlispach, Fabiàn; Hildick‐Smith, David; Nombela‐Franco, Luis; Conradi, Lenard; Hengstenberg, Christian; Reardon, Michael J.; Kasel, Albert M.; Redwood, Simon; Colombo, Antonio; Kar, Saibal; Maisano, Francesco; Windecker, Stephan; Pilgrim, Thomas; Ensminger, Stephan; Prendergast, Bernard; Schöfer, Joachim; Schäefer, Ulrich; Bax, Jeroen J.; Latib, Azeem; Makkar, Raj

doi:10.1016/j.jacc.2017.07.714

Cited by 204 publications

(184 citation statements)

References 35 publications

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“…The transseptal access is associated with fewer procedural complications than is the transapical access. Nonetheless, the transapical access requires a short and rigid delivery catheter for ViV replacement, which might decrease the possibility of the malpositioning of the deployed valve …”

Section: Discussionmentioning

confidence: 99%

Mitral valve‐in‐valve replacement supported by a transapically snared guidewire via septostomy

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Mitral valve‐in‐valve replacement supported by a transapically snared guidewire via septostomy

et al. 2019

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“…Transcatheter MV replacement has been performed in failed mitral bioprosthetic valves (valve‐in‐valve) and failed ring annuloplasty (valve‐in‐ring) in patients at high risk for reoperation. A recent multicentre registry of 248 patients determined feasibility using transcatheter balloon‐expandable aortic valves through a transseptal or transapical access . Mean LVEF in this study was 52.5% ± 13.9%.…”

Section: Transcatheter Mitral Valve Interventionsmentioning

confidence: 99%

“…Technical success was 92.3% at the end of the procedure and 30 day mortality 6.5%. Post‐procedural morbidity as well as 1 year mortality was higher in patients with valve‐in‐ring compared with valve‐in‐valve procedures (28.7% vs. 12.6%) …”

Section: Transcatheter Mitral Valve Interventionsmentioning

confidence: 99%

Mitral valve interventions in heart failure

et al. 2018

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Secondary mitral regurgitation (MR) results from left ventricular dilatation and dysfunction. Quantification of secondary MR is challenging because of the underlying myocardial disease. Clinical and echocardiographic evaluation requires a multi‐parametric approach. Severe secondary MR occurs in up to one‐fourth of patients with heart failure with reduced ejection fraction, which is associated with a mortality rate of 40% to 50% in 3 years. Percutaneous edge‐to‐edge mitral valve repair (MitraClip) has emerged as an alternative to surgical valve repair to improve symptoms, functional capacity, heart failure hospitalizations, and cardiac haemodynamics. Further new transcatheter strategies addressing MR are evolving. The Carillion, Cardioband, and Mitralign devices were designed to reduce the annulus dilatation, which is a frequent and important determinant of secondary MR. Several transcatheter mitral valve replacement systems (Tendyne, CardiAQ‐Edwards, Neovasc, Tiara, Intrepid, Caisson, HighLife, MValve System, and NCSI NaviGate Mitral) are emerging because valve replacement might be more durable compared with valve repair. In small studies, these interventional therapies demonstrated feasibility and efficiency to reduce MR and to improve heart failure symptoms. However, neither transcatheter nor surgical mitral valve repair or replacement has been proven to impact on the prognosis of heart failure patients with severe MR, which remains high with a mortality rate of 14–20% at 1 year. To date, the primary indication for treatment of secondary severe MR is the amelioration of symptoms, reinforcing the value of a Heart Team discussion. Randomized studies to investigate the treatment effect and long‐term outcome for any transcatheter or surgical mitral valve intervention compared with optimized medical treatment are urgently needed and underway.

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“…Los gradientes transvalvulares posprocedimiento fueron similares en ambos grupos (6,4±2,3 mmHg vs 5,8±2,7 mmHg, p=0,17) en tanto que la regurgitación mitral moderada o severa fue más frecuente en el grupo VIR; este grupo tuvo mayor frecuencia de sangrado mayor y de insuficiencia renal aguda (11,1% vs 4,0%, p=0,03). La mortalidad global al año fue significativamente mayor en el grupo VIR comparado con el grupo VIV (28,7% vs 12,6%, log rank test p=0,01) (14) .…”

Section: Evidencia Sobre El Procedimiento Vivmunclassified

“…La utilización de este acceso es variable en diferentes series. En el registro TMVR el acceso transeptal se utilizó en el 33,1% de los casos (14) , en tanto que en el Registro internacional de datos valve-in-valve (VIVID) se utilizó en el 16%, aunque esta frecuencia ha aumentado desde 15% en el inicio del registro hasta 25,4% entre 2014-2015 (17) .…”

Section: Acceso Para Vivmunclassified

Implante de válvulas transcatéter en prótesis valvulares quirúrgicas disfuncionantes: un cambio de paradigma

Vignolo

2017

Rev. Urug. Cardiol.

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ResumenLa disfunción de las bioprótesis quirúrgicas frecuentemente ocurre en pacientes añosos, con severas comorbilidades, lo que implica un riesgo elevado frente a una nueva cirugía valvular. El implante de válvulas transcatéter dentro de biopró-tesis disfuncionantes o procedimiento valve in valve (VIV), ha sido desarrollado como una nueva alternativa terapéutica para este tipo de situación. Los procedimientos VIV deben ser considerados para pacientes con disfunción protésica severa sintomática con alto riesgo quirúrgico, luego de un exhaustivo análisis individualizado por un grupo de expertos o heart team. La selección y evaluación previa de los pacientes son fundamentales para el éxito del procedimiento. La evidencia respalda más fuertemente este tipo de intervención en posición aórtica que en posición mitral. En esta revisión analizamos brevemente las indicaciones, la evaluación previa de los pacientes, los aspectos relevantes del procedimiento y sus complicaciones eventuales, con especial énfasis en el procedimiento VIV mitral, que ha sido motivo de dos recientes reportes de casos en esta revista. Palabras clave: PRÓTESIS VALVULARES CARDÍACAS IMPLANTACIÓN DE PRÓTESIS DE VÁLVULAS CARDÍACAS VALVE IN VALVE MITRAL TRANSCATÉTERTranscatheter valve implantation in dysfunctioning surgical valvular prostheses: a paradigm shift SummaryBioprosthetic surgical valve dysfunction occurs frequently in elderly patients with severe comorbidities, which implies a high surgical risk in case of redo valve surgery. Transcatheter valve implantation within a surgical bioprosthesis, so-called valve in valve procedure (VIV), has been developed as new treatment option for this situation. VIV procedures should be considered in patients with severely symptomatic prosthetic valve dysfunction with high surgical risk, after careful heart team evaluation. Patient selection and pre-procedural evaluation are mainstay for procedural success. Current evidence has stronger support for VIV procedure in aortic than in mitral position. In this review, we briefly analyze VIV procedure indications, patient evaluation, as well as relevant aspects of the procedure itself and its most frequent complications. Special emphasis will be given for VIV in mitral position which has been the focus of two recent case reports in this journal.

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Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings

Abstract: The TMVR procedure provided acceptable outcomes in high-risk patients with degenerated bioprostheses or failed annuloplasty rings, but mitral ViR was associated with higher rates of procedural complications and mid-term mortality compared with mitral ViV.

Cited by 204 publications

References 35 publications

Mitral valve‐in‐valve replacement supported by a transapically snared guidewire via septostomy

Mitral valve‐in‐valve replacement supported by a transapically snared guidewire via septostomy

Mitral valve interventions in heart failure

Implante de válvulas transcatéter en prótesis valvulares quirúrgicas disfuncionantes: un cambio de paradigma

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