Transcatheter valve-in-valve or valve-in-ring mitral valve implantation in young women contemplating pregnancy

Fuchs, Adeline; Alcázar, Marina Ureña; Nguyen, Chau; Brochet, Éric; Abtan, Jérémie; Fischer, Quentin; Ducrocq, Grégory; Iung, Bernard; Vahanian, Alec; Himbert, Dominique

doi:10.1016/j.acvdsp.2019.09.163

Cited by 6 publications

(9 citation statements)

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“…In women considering pregnancy and requiring heart valve replacement, it is recommended to choose the prosthesis in consultation with a pregnancy Heart Team. 554,560 Pregnancy in women with a mechanical valve, especially in the mitral position, is associated with a high risk of maternal and foetal complications, 554,561 which should be carefully discussed with the patient and family.…”

Section: Management Before Pregnancymentioning

confidence: 99%

2021 ESC/EACTS Guidelines for the management of valvular heart disease

Vahanian¹,

Beyersdorf²,

Neumann³

et al. 2021

European Heart Journal

3,325

1,899

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Patient ForumThe content of these European Society of Cardiology (ESC) / European Association for Cardio-Thoracic Surgery (EACTS) Guidelines has been published for personal and educational use only. No commercial use is authorized. No part of the ESC/EACTS Guidelines may be translated or reproduced in any form without written permission from the ESC and the EACTS. Permission can be obtained upon submission of a written request to Oxford University Press, the publisher of the European Heart Journal and the party authorized to handle such permissions on behalf of the ESC (

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Section: Management Before Pregnancymentioning

confidence: 99%

2021 ESC/EACTS Guidelines for the management of valvular heart disease

Vahanian¹,

Beyersdorf²,

Neumann³

et al. 2021

European Heart Journal

3,325

1,899

View full text Add to dashboard Cite

show abstract

Section: Management Before Pregnancymentioning

confidence: 99%

2021 ESC/EACTS Guidelines for the management of valvular heart disease

Vahanian¹,

Beyersdorf²,

Praz³

et al. 2022

EuroIntervention

570

581

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The ESC Guidelines represent the views of the ESC and were produced after careful consideration of the scientific and medical knowledge and the evidence available at the time of their dating. The ESC is not responsible in the event of any contradiction, discrepancy and/or ambiguity between the ESC Guidelines and any other official recommendations or guidelines issued by the relevant public health authorities, in particular in relation to good use of health care or therapeutic strategies. Health professionals are encouraged to take the ESC Guidelines fully into account when exercising their clinical judgment as well as in the determination and the implementation of preventive, diagnostic or therapeutic medical strategies. However, the ESC Guidelines do not override in any way whatsoever the individual responsibility of health professionals to make appropriate and accurate decisions in consideration of each patient's health condition and in consultation with that patient and the patient's caregiver where appropriate and/or necessary. Nor do the ESC Guidelines exempt health professionals from taking careful and full consideration of the relevant official updated recommendations or guidelines issued by the competent public health authorities in order to manage each patient's case in light of the scientifically accepted data pursuant to their respective ethical and professional obligations. It is also the health professional's responsibility to verify the applicable rules and regulations relating to drugs and medical devices at the time of prescription.

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“…The median postprocedural mean gradient was 6 mmHg, which was associated with symptoms relief considering that most of the patients during follow‐up were in Class I or II of the NYHA clinical classification. One may consider that this residual stenosis could have a clinical impact in a less comorbid and more active population, however, ViV and ViR interventions have been found efficient and secure in the particular setting of pregnant women requiring reintervention but considered at high risk for surgery 18 …”

Section: Discussionmentioning

confidence: 99%

“…One may consider that this residual stenosis could have a clinical impact in a less comorbid and more active population, however, ViV and ViR interventions have been found efficient and secure in the particular setting of pregnant women requiring reintervention but considered at high risk for surgery. 18 Baseline echocardiographic characteristics of the ViR group were pejorative with mostly mitral regurgitation with lower ejection fraction.…”

Section: Echocardiographymentioning

confidence: 93%

Mitral valve‐in‐valve and valve‐in‐ring procedures: Midterm outcomes in a French nationwide registry

Ruz

Guérin

Leurent³

et al. 2022

Cathet Cardio Intervent

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Objectives Report contemporary outcomes in patients included in the Mitragister registry and treated with transcatheter mitral valve implantation for failed surgical annuloplasty rings or deteriorated bioprosthesis. Background Midterm survival rates have been reported, but little is known about contemporary morbimortality endpoints. Methods The primary safety outcome was the technical success rate. The primary efficacy composite endpoint was a composite of cardiovascular mortality and heart failure hospitalizations. Results From 2016 to 2021, 102 patients (median age: 81 [74;84] years, 61% female, Euroscore II 11.0% [7.8;16.0]) undergoing valve‐in‐valve (ViV; n = 89) or valve‐in‐ring (ViR; n = 13) procedures were consecutively included. At baseline, ViR group patients had worse left ventricular ejection fraction (50% vs. 60%; p = 0.004) and more frequently severe regurgitation (46% vs. 15%; p = 0.014). The primary safety outcome was 95%: 77% and 98% in the ViR and ViV populations, respectively, (p = 0.014). At intermediate follow‐up (6–12 months) clinical improvement was notable, 88% of the patients were in NYHA class ≤ II (vs. 25% at baseline; p < 0.001). At a mean follow‐up of 17.1 ± 11.0 months, the primary efficacy composite reached 27%. By multivariate analysis, paravalvular leak (PVL) was the only independent predictor (hazard ratio: 2.39, 95% confidence interval: 1.08–5.29; p = 0.031) while ViR was not found statistically associated (p = 0.456). Conclusions This study confirms the safety and efficacy of the mitral ViV procedure. ViR patients appear at higher risk of procedural complications. The presence of PVL could be associated with markedly worse midterm prognosis. Whatever the intervention, procedural strategies to reduce PVL incidence remain to be assessed to prevent latter adverse outcomes.

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Transcatheter valve-in-valve or valve-in-ring mitral valve implantation in young women contemplating pregnancy

Cited by 6 publications

References 0 publications

2021 ESC/EACTS Guidelines for the management of valvular heart disease

2021 ESC/EACTS Guidelines for the management of valvular heart disease

2021 ESC/EACTS Guidelines for the management of valvular heart disease

Mitral valve‐in‐valve and valve‐in‐ring procedures: Midterm outcomes in a French nationwide registry

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