Transfemoral Implantation of a Balloon-Expandable Transcatheter Valve in a Rigid Mitral Annuloplasty Ring Optimized by Post-Dilatation

Regazzoli, Damiano; Stella, Stefano; Pinto, Silvia De; Montorfano, Matteo; Ancona, Marco; Mangieri, Antonio; Buzzatti, Nicola; Giannini, Francesco; Agricola, Eustachio; Monaco, Fabrizio; Alfieri, Ottavio; Colombo, Antonio; Latib, Azeem

doi:10.1016/j.jcin.2017.07.043

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…From 2009 to March 31, 2018, 66 published reports describing 172 patients undergoing TMVIV implantation for degenerated mitral bioprostheses and 35 articles describing 73 patients undergoing TMVIR implantation for failed annuloplasty rings were identified (Figure ). The patients were diagnosed with MR, MS, or mixed lesions according to the articles but the failure modes of 34 patients were unknown.…”

Section: Resultsmentioning

confidence: 99%

Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Chen

Cheng

et al. 2018

J Card Surg

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BackgroundTranscatheter mitral valve‐in‐valve (TMVIV) and valve‐in‐ring (TMVIR) implantation for degenerated mitral bioprostheses and failed annuloplasty rings have recently emerged as treatment options for patients deemed unsuitable for repeat surgery.MethodsA systematic literature review was conducted to summarize the data regarding the baseline characteristics and clinical outcomes of patients undergoing TMVIV and TMVIR procedures.ResultsA total of 245 patients (172 patients who underwent TMVIV surgery and 73 patients who underwent TMVIR surgery) were included in the study; 93.5% of patients experienced successful TMVIV or TMVIR implantation. The mortality rates at discharge, 30 days, and 6 months were 5.7%, 8.1%, and 23.4%, respectively. The transapical (TA) access route was used in most procedures (55.2%). The TA and transseptal (TS) access routes resulted in similar outcomes. No significant differences were observed in the short‐term outcomes between the patients who developed mitral stenosis versus mitral regurgitation as the mode of failure.ConclusionsTMVIV and TMVIR implantation for degenerated mitral bioprostheses and failed annuloplasty rings are safe and effective. Both procedures, via TA or TS access, can result in excellent short‐term clinical outcomes in patients with mitral stenosis or regurgitation, but long‐term follow‐up data are currently lacking to determine the durability of these procedures.

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Section: Resultsmentioning

confidence: 99%

Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Chen

Cheng

et al. 2018

J Card Surg

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“…Rigid rings may retain their original D‐shape even after THV implantation. However, slightly oversizing the THV and high‐pressure postdilatation can minimize PVR in cases of TMVI using complete rigid rings . However, this should be balanced against avoiding implanting underexpanded THVs that may result in impaired leaflet function as well as having a negative impact on durability.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter mitral valve implantation in rigid mitral annuloplasty rings: Potential differences between complete and incomplete rings

Hachinohe

Latib

Montorfano

et al. 2018

Cathet Cardio Intervent

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Transcatheter mitral valve implantation (TMVI) has been performed in high-risk and inoperable patients for degenerated mitral bioprostheses (TMVIinV) and failed annuloplasty rings (TMVIinR). TMVIinR is more challenging compared to TMVIinV because of the differences in dimensions, shapes, and contours between rings and valves. In this report, we present two clinical cases of TMVIinR that were treated by trans-septal implantation of a balloon-expandable prosthesis. In TMVI cases with an incomplete ring, the ring will be stretched out toward its anterior and commissural side, and the open side of the ring will increase in width. The ring may not transform in line with the shape of the transcatheter heart valve (THV) and an interspace can develop between the THV and the ring at the commissural side, resulting in significant paravalvular regurgitation. Our experience suggests that the circumferential completeness of the rings may be an important factor to consider when planning a TMVIinR.

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“…Concerningly, ViR procedures have been reported to have low levels of procedural success (as low as 57.4% 11 and 66.7% 12 in separate studies), high mortality rates (30-day, 1-year, 2-year, and 4-year mortality rates of up to 9.9%, 30.6%, 50%, and 50.3%, respectively, from different studies), and of significant paravalvular leakage rates, which remain the main predictor of mortality at follow-up. 11 , 12 , 13 , 14 , 15 , 16 , 17 …”

mentioning

confidence: 99%

An analytical, mathematical annuloplasty ring curvature model for planning of valve-in-ring transcatheter mitral valve replacement

Park¹,

Marín-Cuartas²,

Sellke³

et al. 2023

JTCVS Techniques

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Transfemoral Implantation of a Balloon-Expandable Transcatheter Valve in a Rigid Mitral Annuloplasty Ring Optimized by Post-Dilatation

Cited by 5 publications

References 2 publications

Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Transcatheter mitral valve implantation for degenerated mitral bioprostheses or failed surgical annuloplasty rings: A systematic review and meta-analysis

Transcatheter mitral valve implantation in rigid mitral annuloplasty rings: Potential differences between complete and incomplete rings

An analytical, mathematical annuloplasty ring curvature model for planning of valve-in-ring transcatheter mitral valve replacement

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