Courtesy of Dr. Carlos Fava. The risk of repeat surgical mitral valve repair involves 6% to15% mortality at 30 days, even close to 20% in acute cases. However, mortality can rise to over 40% when it comes to a third or fourth surgical intervention. One of the solutions to this serious problem is transcatheter mitral…
Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points
After transcatheter mitral valve repair with MitraClip, the COAPT patients saw improved quality of life, better survival rate and fewer hospitalizations for cardiac failure at long term follow-up. Improved quality of life had already been presented, exactly one year ago at the ACC 2019. In that occasion, it was established that the MitraClip reduces symptoms…
Virtual ACC 2020 | Unlike in TAVR, the Number of Mitral Valve Surgeries Does Not Improve the Outcomes of Transcatheter Mitral Valve Repairs
Soon, our website will feature an interesting study showing that sites with a higher number of conventional surgical aortic valve replacements had better outcomes in transcatheter aortic valve replacement procedures. The study featured in this article was scheduled for presentation at the American College of Cardiology 2020 Scientific Session along the World Congress of Cardiology.…
Percutaneous Annuloplasty in Functional Mitral Regurgitation vs. Sham Procedure
In cases where it is difficult to demonstrate the improvement of a drug or a device in hard endpoints such as mortality, we should look for softer and easier to prove endpoints. The problem is that these soft endpoints are often subjective (such as sensation of shortness of breath or angina pectoris) and they could…
Venous Pulmonary Waveforms in MitraClip Have Prognostic Value
Courtesy of Dr. Carlos Fava. The MitraClip has been shown to benefit a certain group of patients and it is a well-known fact that a ≥5 mmHg is associated to a more torpid evolution. However, there is little evidence when it comes to venous pulmonary waves, changes in left atrial pressure and V wave. 121…
1000 MitraClips: Results from the World’s Most Experienced Site
In September 2008, interventional physicians at the Heart and Vascular Centre Hamburg conducted the first MitraClip implantation after its Conformité Européenne (CE)-marking approval. In July 2019, the same site reached an amazing milestone, 1000 MitraClips implanted, and in doing so it became the most experienced site in the world. Those 1000 patients treated had an average logistic…
TCT 2019 | PARTNER 2A at 5 Years: In Intermediate-Risk Patients, TAVR Is Still Head-to-Head with Surgery
Courtesy of the SBHCI. The 2-year results of the PARTNER 2A trial showed that transcatheter aortic valve implantation has a result similar to that of surgery in patients with aortic stenosis and intermediate surgical risk. We lacked long-term data, both clinical and related to prosthesis function. Now, at TCT 2019, researchers presented the 5-year data for this…
TCT 2019 | Mitral Valve-in-Valve: 1-Year Results for Sapien 3 in Mitral Valve Replacement for Degenerated Bioprostheses
Courtesy of SBHCI. The aim of this work was to assess the contemporary outcomes of mitral valve-in-valve using Sapien 3 prostheses, see the differences between trasapical and transseptal access, and establish 1-year mortality predictors. Researchers analyzed retrospectively the data from the Society of Thoracic Surgeons [STS]/American College of Cardiology TVT Registry, which included 1576 patients who had…
MitraClip in the Real World: Mid-Term Progress
Courtesy of Dr. Carlos Fava. The fact that the outcomes of edge-to-edge repair with MitraClip have improved, particularly in the immediate and short term, is widely known. Such improvement is basically a result of more operator experience and the arrival of 3-D echocardiography. However, there are no mid-term follow-up studies available, except for the EVEREST…
ESC 2019 | MITRA-FR: 2-Year Outcomes of One of the Largest Studies on MitraClip
Negative one-year outcomes of Mitra-FR led to several discussions and hypothesis, especially after the COAPT was published only a few weeks later. According to the COAPT study, the MitraClip was able to reduce hospitalization rate for cardiac failure and also all-cause mortality, compared against optimal medical treatment alone. When comparing the COAPT to the Mitra-FR,…
Can We Treat Severe Residual Mitral Regurgitation after MitraClip without Surgery?
Courtesy of Dr. Carlos Fava. Edge to edge with MitraClip was shown effective and safe, and its outcomes have been improving over these past few years. However, one of its greatest challenges involves not being able to reduce mitral regurgitation (MR) after device implantation, resulting in the need for surgery, as some studies have shown…