Courtesy of Dr. Carlos Fava. Mitral regurgitation accounts for around 25% of valvular diseases and is a strong mortality predictor in heart disease. One of the challenges of this disease is that patients respond favorably to medical treatment for a long time, which makes hard to establish the right time to perform an intervention without…
Treating Tricuspid and Mitral Valves with MitraClip Improves Quality of Life
Courtesy of Dr. Carlos Fava. It has been shown that significant tricuspid regurgitation (TR) is an independent predictor of bad evolution in the presence of mitral valve disease. Its prevalence is not low, reaching up to 50% in patients undergoing surgery for mitral regurgitation (MR). This study included 61 patients with significant TR and MR. 27…
Tricuspid Regurgitation: MitraClip Improves Survival
Courtesy of Dr. Carlos Fava. Tricuspid regurgitation (TR), both isolated or associated with other left valve diseases, has been associated with higher rates of heart failure hospitalization and of cardiovascular death. Recent studies in elderly high-risk patients who underwent percutaneous treatment of left valve disease have shown the presence of TR to be associated with…
We Should Consider Mitral Stenosis Before TAVR
The association between aortic stenosis and some degree of mitral stenosis (MS) is around 10% (depending on the series), and it is related with negative outcomes. In high-risk and inoperable patients who underwent TAVR, that association and its significance have not been studied yet. The study analyzed data from the Society of Thoracic Surgeons/American…
Surgical or Percutaneous Management of Mitral Leak
Mitral paravalvular leaks are relatively common after surgical mitral replacement, with an incidence of 7%-17%. Most of these are subclinical leaks, a mere echocardiogram finding, but about 3% of patients can develop heart failure, hemolysis, or a combination of both, thus requiring a new intervention. For symptomatic patients, new surgery has been the traditional treatment…
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. However,…
Mitral Valve Repair with MitraClip Is Safe in High-Risk Patients
Courtesy of Dr. Carlos Fava. Transcatheter mitral valve repair with MitraClip has shown good results in symptomatic patients with extreme surgical risk in different studies. However, its “real world” benefits have not been studied in depth due to how complex this strategy is compared with other usual procedures. This study analyzed 2952 patients who underwent mitral…
TCT 2017 | INTREPID: Mitral Replacement with a Self-Expanding Device
Courtesy of the SBHCI. Intrepid is a 43-, 46-, and 50-mm nitinol self-expanding valve with bovine pericardial leaflets that is placed using a transapical delivery system with a 35-Fr access. This pilot study enrolled 50 patients with severe mitral regurgitation who were symptomatic and at a high surgical risk, or in whom surgery was contraindicated. Read…
TCT 2017 | MAVERIC: Results 6 Months After Transcatheter Mitral Valve Replacement
Courtesy of the SBHCI. This seems to be the year for transcatheter mitral valve devices, and the ARTO system tested in this study looks promising for the treatment of patients with severe mitral regurgitation who are symptomatic due to heart failure and ejection fraction <40%. The study enrolled 50 patients who underwent clinical and ecocardiographic follow-up…
MitraClip Procedure Can Be Performed without General Anesthesia
Courtesy of Dr. Carlos Fava. Avoiding general anesthesia in intervention procedures has the benefits of faster recovery and shorter hospitalization. This has been already analyzed in the context of TAVR, but not in MitraClip procedures. The present study analyzed 232 patients receiving the MitraClip. 76 of these procedures were done under general anesthesia (32.7%) and…
Transcatheter Reduction or Surgery for Paravalvular Leak Repair?
Paravalvular leak is complication derived from incomplete sealing between the implanted prosthesis and the native annulus, which occurs in 5% of all patients who undergo mitral valve replacement and 10% of those who undergo transcatheter aortic valve replacement. This is the most frequent non-structural valve dysfunction. While mild leaks can be asymptomatic, moderate to severe…