The trans-septal approach in transcatheter mitral valve-in-valve implantation for degenerative bioprosthesis.
Degenerated mitral bioprosthesis
Trans-septal mitral valve in valve
Transcatheter mitral valve implantation
Journal
Journal of the Saudi Heart Association
ISSN: 1016-7315
Titre abrégé: J Saudi Heart Assoc
Pays: Saudi Arabia
ID NLM: 9887261
Informations de publication
Date de publication:
2020
2020
Historique:
received:
22
12
2019
revised:
04
01
2020
accepted:
17
01
2020
entrez:
6
11
2020
pubmed:
7
11
2020
medline:
7
11
2020
Statut:
epublish
Résumé
Transcatheter Mitral Valve-in-Valve Implantation (TMViVI) has recently emerged as a novel therapy for degenerated mitral valve bioprosthesis. Re-operative mitral valve surgery is associated with a substantial risk of mortality and morbidity. The objective of this study was to describe the outcomes of transcatheter mitral valve-in-valve implantations in our cardiac center. Twenty-two patients underwent the valve-in-valve procedure because of bioprosthesis degeneration from March 2017 to October 2018. Clinical, echocardiographic, procedural details and survival at follow up were assessed. Eight patients refused re-operative cardiac surgery while others were deemed a high risk for conventional re-operative sternotomy. All patients had TMViVI performed via a trans-septal approach, and the prosthesis was implanted successfully with immediate hemodynamic improvement in 20 patients. One patient had tamponade (4.55%), two had permanent pacemaker insertion (9.09%), two patients had a renal impairment (9.09%), and three patients had vascular complications (13.64%). There was one aborted procedure for the failure to cross the tissue valve with a transcatheter valve, and one patient was converted to an emergency mitral valve surgery. All patients were discharged in NYHA class I/II and NYHA class was markedly improved at one-year follow-up (p = 0.002). Trans-septal mitral valve-in-valve implantation can be performed safely for degenerative mitral valve bioprosthesis and with favorable early clinical and hemodynamic outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Transcatheter Mitral Valve-in-Valve Implantation (TMViVI) has recently emerged as a novel therapy for degenerated mitral valve bioprosthesis. Re-operative mitral valve surgery is associated with a substantial risk of mortality and morbidity. The objective of this study was to describe the outcomes of transcatheter mitral valve-in-valve implantations in our cardiac center.
METHODS
METHODS
Twenty-two patients underwent the valve-in-valve procedure because of bioprosthesis degeneration from March 2017 to October 2018. Clinical, echocardiographic, procedural details and survival at follow up were assessed.
RESULTS
RESULTS
Eight patients refused re-operative cardiac surgery while others were deemed a high risk for conventional re-operative sternotomy. All patients had TMViVI performed via a trans-septal approach, and the prosthesis was implanted successfully with immediate hemodynamic improvement in 20 patients. One patient had tamponade (4.55%), two had permanent pacemaker insertion (9.09%), two patients had a renal impairment (9.09%), and three patients had vascular complications (13.64%). There was one aborted procedure for the failure to cross the tissue valve with a transcatheter valve, and one patient was converted to an emergency mitral valve surgery. All patients were discharged in NYHA class I/II and NYHA class was markedly improved at one-year follow-up (p = 0.002).
CONCLUSIONS
CONCLUSIONS
Trans-septal mitral valve-in-valve implantation can be performed safely for degenerative mitral valve bioprosthesis and with favorable early clinical and hemodynamic outcomes.
Identifiants
pubmed: 33154908
doi: 10.37616/2212-5043.323
pii: sha-32-02-141
pmc: PMC7640552
doi:
Types de publication
Journal Article
Langues
eng
Pagination
141-148Informations de copyright
© 2020 Saudi Heart Association.
Déclaration de conflit d'intérêts
The authors have nothing to disclose.
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