Courtesy of the SBHCI.
The risk of surgical mitral valve replacement in patients with significant annular calcification is very high. There are isolated reports of transcatheter mitral valve replacement with balloon-expandable valve in this patient population. In consequence, this multicenter registry tries to concentrate information and analyzes the outcomes a year after the procedure.
The study enrolled 116 patients in 51 centers and 11 countries between 2012 and 2017, who had a mean Society of Thoracic Surgeons (STS) score of 15.3% and a mean transmitral gradient of 11.5 mmHg.
The main approaches were transapical (40%) and transeptal (40%). The procedure was considered successful in 76.7% of patients, since 11.2% presented outflow tract obstruction and 14.7% required a second valve.
The rate of all-cause mortality was 25% at 30 days and 54.7% at 1 year. The most influential variable regarding cardiac death was outflow tract obstruction.
Conclusion
It is clear that treatment of the mitral valve is complex, with a high rate of paravalvular leak evidenced by the need for a second valve and the risk of outflow tract obstruction.
Courtesy of the SBHCI.
Original title: 1-Year Outcomes of Transcatheter Mitral Valve Replacement in Native Mitral Valve Disease with Severe Mitral Annular Calcification: Update from the First Global Registry.
Presenter: Mayra Guerrero.
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