Transcatheter Myotomy to Treat Hypertrophic Cardiomyopathy and Enable Transcatheter Mitral Valve Replacement: First-in-Human Report of Septal Scoring Along the Midline Endocardium

Greenbaum, Adam; Khan, Jaffar M.; Bruce, Christopher G.; Hanzel, George; Gleason, Patrick; Kohli, Keshav; Inci, Errol; Guyton, Robert A.; Paone, Gaetano; Rogers, Toby; Lederman, Robert J.; Babaliaros, Vasilis

doi:10.1161/circinterventions.122.012106

Cited by 27 publications

(9 citation statements)

References 5 publications

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“…Complications included VSD in two animals and mitral chord rupture in one animal. Subsequently, a first‐in‐human case report showed a successful SESAME procedure 71 . Currently, SESAME is for compassionate use only and is yet to be FDA‐approved.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of present and future pharmaco‐structural therapies for hypertrophic cardiomyopathy

Sawan,

Prabakaran,

D'Souza

et al. 2024

Clinical Cardiology

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Hypertrophic cardiomyopathy (HCM) is a common contemporary, treatable, genetic disorder that can be compatible with normal longevity. While current medical therapies are ubiquitous, they are limited by a lack of solid evidence, are often inadequate, poorly tolerated, and do not alter the natural disease course. As such, there has long been a need for effective, evidence‐based, and targeted disease‐modifying therapies for HCM. In this review, we redefine HCM as a treatable condition, evaluate current strategies for therapeutic intervention, and discuss novel myosin inhibitors. The majority of patients with HCM have elevated left ventricular outflow tract gradients, which predicts worse symptoms and adverse outcomes. Conventional pharmacological therapies for symptomatic HCM can help improve symptoms but are often inadequate and poorly tolerated. Septal reduction therapies (surgical myectomy and alcohol septal ablation) can safely and effectively reduce refractory symptoms and improve outcomes in patients with obstructive HCM. However, they require expertise that is not universally available and are not without risks. Currently, available therapies do not alter the disease course or the progressive cardiac remodeling that ensues, nor subsequent heart failure and arrhythmias. This has been regarded as an unmet need in the care of HCM patients. Novel targeted pharmacotherapies, namely cardiac myosin inhibitors, have emerged to reverse key pathophysiological changes and alter disease course. Their favorable outcomes led to the early Food and Drug Administration approval of mavacamten, a first‐in‐class myosin modulator, changing the paradigm for the pharmacological treatment of HCM.

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Section: Resultsmentioning

confidence: 99%

A systematic review of present and future pharmaco‐structural therapies for hypertrophic cardiomyopathy

Sawan,

Prabakaran,

D'Souza

et al. 2024

Clinical Cardiology

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“…The resultant myotomy immediately reduces LVOT gradient and splays further over 30 days. 77 In early experience, there have been no major conduction disturbances and few anatomic exclusions, in contrast to transcoronary alcohol septal ablation. 80…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…LVOT obstruction may still occur from TMVR when the transcatheter heart valve fabric skirt obstructs outflow despite successful LAMPOON. 76 The SESAME procedure, 77,78 still under development, is a transcatheter septal myotomy that increases LVOT area in patients with, or at risk for, LVOT obstruction from TMVR, or hypertrophic cardiomyopathy (Figure 7).…”

Section: Sesame (Septal Scoring Along Midline Endocardium)mentioning

confidence: 99%

Transcatheter Electrosurgery: A Narrative Review

Bruce

Khan

Rogers

et al. 2023

Circ: Cardiovascular Interventions

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Transcatheter electrosurgery describes the ability to cut and traverse tissue, at a distance, without an open surgical field and is possible using either purpose-built or off-the-shelf devices. Tissue traversal requires focused delivery of radiofrequency energy to a guidewire tip. Initially employed to cross atretic pulmonary valves, tissue traversal has enabled transcaval aortic access, recanalization of arterial and venous occlusions, transseptal access, and many other techniques. To cut tissue, the selectively denuded inner curvature of a kinked guidewire (the Flying-V) or a single-loop snare is energized during traction. Adjunctive techniques may complement or enable contemporary transcatheter procedures, whereas myocardial slicing or excision of ectopic masses may offer definitive therapy. In this contemporary review we discuss the principles of transcatheter electrosurgery, and through exemplary clinical applications highlight the range of therapeutic options offered by this versatile family of procedures.

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“…49 Transcatheter septal myotomy by septal scoring along the midline endocardium has been developed and shown successful results in a first-human report (Figure 4). 50…”

Section: Measures To Prevent Lvot Obstructionmentioning

confidence: 99%

Transcatheter Mitral Valve Replacement in Failed Bioprosthetic Valve, Ring, and Mitral Annular Calcification Associated Mitral Valve Disease Using Balloon Expandable Transcatheter Heart Valve

Ueyama¹,

Gleason²,

Babaliaros³

et al. 2023

Methodist DeBakey Cardiovascular Journal

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Transcatheter mitral valve replacement (TMVR) using the SAPIEN platform has been performed in failed bioprosthetic valves (valve-in-valve), surgical annuloplasty rings (valve-in-ring), and native valves with mitral annular calcification (MAC) (valve-in-MAC). Experience over the past decade has identified important challenges and solutions to improve clinical outcomes. In this review, we discuss the indication, trend in utilization, unique challenges, procedural planning, and clinical outcomes of valve-in-valve, valve-inring, and valve-in-MAC TMVR.

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Transcatheter Myotomy to Treat Hypertrophic Cardiomyopathy and Enable Transcatheter Mitral Valve Replacement: First-in-Human Report of Septal Scoring Along the Midline Endocardium

Cited by 27 publications

References 5 publications

A systematic review of present and future pharmaco‐structural therapies for hypertrophic cardiomyopathy

A systematic review of present and future pharmaco‐structural therapies for hypertrophic cardiomyopathy

Transcatheter Electrosurgery: A Narrative Review

Transcatheter Mitral Valve Replacement in Failed Bioprosthetic Valve, Ring, and Mitral Annular Calcification Associated Mitral Valve Disease Using Balloon Expandable Transcatheter Heart Valve

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