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…
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…
EuroPCR 2020 | EVOQUE: New Transcatheter Mitral Valve Replacement System, Promises at Short Term and Future Hope
Transeptal transcatheter mitral valve replacement offers a less invasive alternative vs. surgery and with fewer anatomical limitations than transcatheter repair (e.g. MitraClip) in patients with severe mitral valve failure. The first patients treated with the new system EVOQUE were included between September 2018 and October 2019 and its outcomes were presented at the virtual EuroPCR…