Transcatheter Mitral Valve Replacement Devices Multiply

The Transcatheter mitral valve replacement has been established as gold standard for patients with intermediate or high risk severe aortic stenosis. The supporting evidence was initially gathered with one or two safe and effective devices that worked really well, so that later on prosthetic valves multiplied, for competing companies wanted their share of the market.

Proliferan los dispositivos para el reemplazo valvular mitral por catéter

However, transcatheter mitral valve replacement is still in its infancy; it can be offered to patients with symptomatic mitral valve regurgitation as a less invasive option when extreme risk rules out conventional surgery. Devices have also multiplied ─as in the case of aortic valves─ but it seems there are too many simply because there is no perfect one.


Read also: Five-Year Outcomes for Appendage Closure”.


 

Device implantation was successful in 48 patients, with a 14-minute deployment time. Mortality at 30 days was 14%, with no disabling strokes or repeat interventions.


Read also: TCT 2017 | INTREPID: Mitral Replacement with a Self-Expanding Device”.


Mean follow up was 173 days (range 54 to 342 days) when the last echocardiogram in each patient confirmed mild or no residual regurgitation, consistent with significant improvement of symptoms. 79% of patients reported functional class I or II at follow up (p<0.0001 compared against baseline).

 

Conclusion

Transcatheter mitral valve replacement with this new device resulted feasible in this high or extreme risk population. These results lay the groundwork for a larger study with patients al lower risk.

 

Editorial Comment

The smaller profile of this valve allowed implantation in conditions previously counter indicated (such as prior transcatheter aortic valve replacement), particularly in women and in small ventricles where the risk of outflow tract obstruction can be high.

 

Apical bleeding was associated to 3 deaths, which raises an obvious concern and calls for perfecting this technique and which, when deemed unsafe, will eventually make us decide against this procedure.  At present, a new trans septal delivery system is being developed to avoid the need of minimal thoracotomy and its complications.

 

Original title: Early Experience with New Transcatheter Mitral Valve Replacement.

Referemce: Vinayak Bapat et al. J Am Coll Cardiol 2018;71:12–21.


Suscríbase a nuestro newsletter semanal

Reciba resúmenes con los últimos artículos científicos

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

TCT 2024 | TRISCEND II: A New Hope in Percutaneous Tricuspid Valve Replacement

Advanced tricuspid regurgitation (TR) is a debilitating disease associated with heart failure and increased mortality.  Edge-to-edge repair has been shown to improve both clinical condition...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....