New Transcatheter Mitral Valve Treatment (original) (raw)
Related papers
Transcatheter mitral valve regurgitation treatment: State of the art and a glimpse to the future
The Journal of thoracic and cardiovascular surgery, 2016
Since the first transcatheter heart valve implantation in the pulmonary position in 2000 and in the aortic position in 2002, a large number of transcatheter heart valves have reached the clinical arena and thousands of high-risk patients have been treated successfully, in particular those with severe aortic stenosis. In contrast, the experience of transcatheter mitral valve repair or implantation started relatively more recently, and only a few devices are available at the moment. The aim of this review is to describe the different percutaneous systems for the treatment of mitral regurgitation.
Transcatheter mitral valve interventions: current status and future perspective
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2012
With the recent developments in the field of transcatheter aortic valve replacement for aortic stenosis there has been a similar advance in the field of transcatheter mitral valve therapy for mitral regurgitation (MR). Both the anatomy of the mitral apparatus and the spectrum of pathology of MR are more complex than for aortic valve disease, and thus the development of MR therapies has been more complicated and less rapid. The purpose of this review of recent literature is to provide a synopsis of the present technologies under development for percutaneous therapy for MR. Leaflet repair with MitraClip has accrued the largest human experience among the technologies that are under development, having been used to treat over 6,000 patients. MitraClip is currently being used in patients with functional MR and at high risk for conventional surgery. Coronary sinus, or indirect annuloplasty, has the next largest clinical experience, with several hundred patients treated in trials. Other MR...
Emerging Technologies for Percutaneous Mitral Valve Repair
Frontiers in Cardiovascular Medicine, 2019
Mitral regurgitation (MR) is a common disease affecting more than 4 million people in the United States and the European Union. A significant number of percutaneous valves have been developed recently, specifically designed for the mitral anatomy, and with a promising evidence of good procedural and echocardiographic outcomes. However, even if transcatheter mitral valve replacement (TMVR) will have a role in the future of percutaneous treatment of both functional and degenerative mitral regurgitation, percutaneous mitral valve repair will always play a vital role in the treatment of MR because of the favorable safety profile and the fact that it respects the native anatomy. In this review, we will discuss the new emerging technologies under development to treat mitral regurgitation focusing on different devices that aim to target different components of the mitral anatomy.
Clinical trial experience with the MitraClip catheter based mitral valve repair system
The International Journal of Cardiovascular Imaging, 2011
Severe mitral regurgitation (MR) confers a poor prognosis, in particular for patients with heart failure. Based on the results of the Euro Heart Survey, a large proportion of patients with mitral regurgitation is not referred to surgery and many other patients are rejected for cardiac surgery due to the high surgical risk or co-pathologies. Improving ventricular function with ACE inhibitors, beta-blockers and CRT may reduce mitral regurgitation, but for most patients a mechanical intervention is ultimately preferable. Mitral valve surgery is invasive and requires a long recovery period; therefore, less invasive and effective approaches are highly desirable, particularly in high risk patients. Therefore, new techniques have been recently developed to treat MR with percutaneous approach. The MitraClip device (Abbott Vascular, Menlo Park, CA) is used to treat both functional and degenerative mitral valve regurgitation. Its safety and efficacy has been initially tested in the Endovascular Valve Edge-to-Edge REpair Study (EVEREST), while MitraClip has been compared to surgery in the EVEREST II randomized trial. Besides EVEREST trials, safety and efficacy of the device as well as its health economic value is under evaluation in ongoing registries. Although the field of catheter based management of MR is at an early stage, initial clinical results have demonstrated that catheter based approaches can reduce MR, suggesting there is a great deal of potential for clinical benefit to patients with MR.
Transcatheter approaches for mitral valve regurgitation
Journal of Visualized Surgery, 2019
Surgical repair for a longtime was and currently is regarded as the gold-standard for the treatment of mitral regurgitation (MR). With an aging population, significant MR became not only more prevalent, but also fundamental for development of transcatheter devices for patients at high surgical risk. After successful attempts in transcatheter mitral valve reconstruction two decades ago, successful transcatheter mitral valve replacement (TMVR) was performed for the first time in 2012. Currently several repair-systems are available and a couple of them proved to be even superior to conventional surgery in selected patient populations. Since the mitral valve (MV) apparatus is a complex anatomical structure, progress in development of TMVR took longer than in transaortic valve replacement (TAVR). We aim at giving insight in current standards of transcatheter treatments for severe MR by critically reviewing the latest literature.
Current Percutaneous Approaches to Treat Mitral Valve Regurgitation
Current Treatment Options in Cardiovascular Medicine, 2024
Purpose of review In recent years, our understanding of mitral regurgitation and its management has evolved substantially. In particular, as percutaneous mitral valve interventions have proven safe and effective, it has become possible to offer expanded therapeutic options to patients who are deemed inoperable or at high surgical risk. This review provides an overview of currently available transcatheter mitral valve interventions and summarizes recently published findings that may allow for better risk stratification, patient selection, and procedural safety and efficacy. Recent findings In the last 1-2 years, numerous studies have provided important insights that help to better characterize patients in clinical practice and to select them more optimally for specific interventional mitral valve procedures. Summary The evolution of percutaneous MV therapy has been substantial and extremely beneficial for patient care. Nonetheless, this is an area underdevelopment and newer or enhanced devices are likely to emerge in the future.
Advances in Interventional Cardiology, 2013
P Pi io ot tr r K Kü üb bl le er r 1 1 , , D Do or ro ot ta a K Ku us st tr rz zy yc ck ka a--K Kr ra at to oc ch hw wi il l 1 1 , , A Ar rt tu ur r T Te el li ic ch ho ow ws sk ki i 1 1 , , T To om ma as sz z W Wi it tk ko ow ws sk ki i 1 1 , , W Wa al ld de em ma ar r B Ba an na as si ia ak k 1 1 , , E Ew wa a A A. . J Ja an nk ko ow ws sk ka a 1 1, ,2 2 , , P Pi io ot tr r P Po on ni ik ko ow ws sk ki i 1 1, ,2 2 , , K Kr rz zy ys sz zt to of f R Re ec cz zu A b s t r a c t Treatment of hemodynamically significant valvular heart diseases has been the domain of cardiac surgery for decades. However, a promising novel method is the MitraClip system, involving percutaneous connection of insufficient valve leaflets with special cobalt-chrome clips. Our study presents clinical characteristics, course of treatment with the MitraClip system, and immediate and 90-day clinical and echocardiographic follow-up of the first 3 patients treated in our institution. Subsequently, based on data from the literature and our own experience, the current position around the world, and the target group of patients who are most likely to benefit from treatment using the MitraClip system, are discussed.
The Evolution From Surgery to Percutaneous Mitral Valve Interventions
Journal of the American College of Cardiology, 2011
The edge-to-edge technique is a versatile procedure for mitral valve repair. Its technical simplicity has been the prerequisite for the development of a number of transcatheter technologies to perform percutaneous mitral valve repair. The evolution from a standard open heart surgical to percutaneous procedure involved the application of the technique in minimally invasive robotic surgery and direct access (transatrial) off-pump suture-based repair and finally in the fully percutaneous approach with either suture-based or device (clip)-based approach. The MitraClip (Abbott Vascular, Menlo Park, California) is currently available for clinical use in Europe, and it is mainly applied to treat high-risk patients with functional mitral regurgitation. A critical review of the surgical as well as the early percutaneous repair data is necessary to elucidate the clinical role and the potential for future developments of the edge-to-edge repair in the treatment of mitral regurgitation.