Read articles on the main presentations of the first day of SOLACI-CACI 2017 Congress. See the presentation by Dr. Samir Kapadia, entitled “Clinical results of Mitraclip in degenerative mitral valve regurgitation”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
Similar mortality outcomes with MitraClip and surgery in high risk patients with severe mitral valve regurgitation
Original title: Survival of transcatheter mitral valve repair compared with surgical and conservative treatment in high-surgical-risk patients. Reference: Swaans MJ et al. J Am CollCardiolIntv. 2014;7:875-881. In high-surgical-risk patients with symptomatic severe mitral valve regurgitation, MitraClip for transcatheter mitral valve repair and surgery showed similar survival rates in addition to superiority when compared to standard medical treatment. This...
Promising Results of Transcatheter Mitral Valve Replacement in Bioprosthesis Failure
Failure of a mitral bioprosthesis always poses a challenge regarding decision-making, especially when dealing with elderly patients with multiple risk factors. The scenario is worsened by the high risk associated with a new sternotomy and the significant impact of undergoing new surgery. Transcatheter mitral valve-in-valve (TMViV) replacement is emerging as a valid strategy in the...
Transcatheter Mitral Valve Replacement: DOAC or VKA?
Severe mitral disease is common and currently constitutes a frequent cause of hospitalization and death. While surgery is the treatment of choice, transcatheter mitral valve replacement (TMVR) emerges as a valid alternative in cases of bioprosthesis failure, ring malfunction, or severe mitral annular calcification (MAC). Furthermore, the latest medical guidelines support the recommendation of TMVR...
Tricuspid Regurgitation: Natural Progression and Prognosis
The prevalence of tricuspid regurgitation (TR) is significant; its prognosis is well known, and severe TR stages are associated with higher mortality and hospitalization for cardiac failure (CF). Seeing as valve disease tends to evolve over time, in advanced stages, we usually check on patients at specified intervals for early identification of potential hemodynamic complications...
MITRAL Trial, Results at 5 Years
Repeat mitral valve repair has been associated with increased mortality. Transcatheter mitral valve repair has surged as an alternative for patients treated with mitral valve-in-valve (MViV), valve-in-ring (MViR), or valve-in-mitral for annular calcification (ViMAC). Current data from the VIVID and the MAC Global Registry on 30-day evolution in these 3 scenarios show 7.4%, 11.4% and...
Mitral Valve Edge to Edge Repair for Papillary Muscle Rupture after Acute Myocardial Infarction
With an approximate incidence of 0.05% to 0.25%, post-acute myocardial infarction (AMI) mitral valve failure caused by papillary muscle rupture is not exactly common. However, it is associated to high mortality rate, ranging between 36% and 80%. Current guidelines recommend surgical treatment, but more often than not surgery involves prohibitive or extremely high risk, with...
Transcatheter Mitral Valve Replacement vs. Medical Therapy
Mitral valve regurgitation (MR) is a common cause behind heart failure and is associated to hospitalization for heart failure and higher mortality. Transcatheter edge-to-edge repair (TEER), together with guideline-directed medical therapy (GDMT) has been shown beneficial in high risk patients, according to the COAPT study. However, there is a significant group of patients that make...
Mitral Valve Surgery after Edge-to-Edge Repair
In last few years, transcatheter edge-to-edge repair (TEER) with MitraClip has been shown safe and effective, both for primary and secondary mitral valve regurgitation (MR), given the increasing interventionist and echocardiographer experience. However, there is a group of patients that require surgery after failed TEER, either because of bad evolution or because device implantation...
Echo- Stress during Edge-to-Edge Mitral Valve Repair Can Be Useful
Transcatheter edge-to-edge mitral valve repair with Mitraclip has become a valid strategy to treat mitral valve regurgitation (MR) when surgery is not viable. However, after discharge, residual MR (>moderate) can affect over 10% of patients, because of the use of anesthesia, which alters pre and post procedural measurements. In this context, eco-stress could become a...