338 * Transcatheter Mitral Valve Implantation via Transapical Approach: Early Experience

Søndergaard, Lars; Brooks, Matthew; Ihlemann, Nikolaj; Jönsson, Anders; Holme, Susanne; Tang, Mariann; Terp, Kim; Quadri, A

doi:10.1093/icvts/ivu276.338

Cited by 2 publications

(3 citation statements)

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“…On the one hand, a transapical approach can be selected, since the imaginary central axis between annulus and apex of the left ventricle (LV) can usually be projected well and determined by CT ( Fig. 4 ) 20 21 22 23 . On the other hand, the less invasive transfemoral-transseptal access is also an option for prosthesis implantation, which does not require opening of the thorax by mini-thoracotomy as in the transapical approach, thus allowing a purely endovascular procedure 24 .…”

Section: Available Devicesmentioning

confidence: 99%

“…Hierfür kann einerseits ein transapikaler Zugangsweg gewählt werden, da hier die gedachte zentrale Achse zwischen Annulus und Apex des linken Ventrikels (LV) meist gut projiziert und mittels CT bestimmt werden kann ( Abb. 4 ) 20 21 22 23 . Anderseits stellt auch der weniger invasive transfemoral-transseptale Zugangsweg eine Möglichkeit zur Prothesenimplantation dar, bei der keine Eröffnung des Thorax mittels Mini-Thorakotomie wie beim transapikalen Zugangsweg erforderlich ist, womit ein rein endovaskuläres Vorgehen möglich ist 24 .…”

Section: Verfügbare Devicesunclassified

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CT Planning prior to Transcatheter Mitral Valve Replacement (TMVR)

Heiser

Gohmann

Noack

et al. 2022

Rofo

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Background Transcatheter mitral valve replacement (TMVR) is a treatment option for patients with therapy refractory high-grade mitral valve regurgitation and a high perioperative risk.During TMVR, the mitral annulus cannot be visualized directly. Therefore, comprehensive pre-interventional planning and a precise visualization of the patient’s specific mitral valve anatomy, outflow tract anatomy and projected anchoring of the device are necessary.Aim of this review-article is, to assess the role of pre-procedural computed tomography (CT) for TMVR-planning Methods Screening and evaluation of relevant guidelines (European Society of Cardiology [ESC], American Heart Association [AHA/ACC]), meta-analyses and original research using the search terms “TVMR” or “TMVI” and “CT”. In addition to this, the authors included insight from their own clinical experience. Results CT allows for accurate measurement of the mitral annulus with high special and adequate temporal resolution in all cardiac phases. Therefore, CT represents a valuable method for accurate prosthesis-sizing.In addition to that, CT can provide information about the valvular- and outflow-tract-anatomy, mitral valve calcifications, configuration of the papillary muscles and of the left ventricle. Additionally, the interventional access-route may concomitantly be visualized. Conclusion CT plays, in addition to echocardiographic imaging, a central role in pre-interventional assessment prior to TMVR. Especially the precise depiction of the left ventricular outflow tract (LVOT) provides relevant additional information, which is very difficult or not possible to be acquired in their entirety with other imaging modalities. Key Points: Citation Format

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Section: Available Devicesmentioning

confidence: 99%

Section: Verfügbare Devicesunclassified

CT Planning prior to Transcatheter Mitral Valve Replacement (TMVR)

Heiser

Gohmann

Noack

et al. 2022

Rofo

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“…1 Also, considering the steady growth in real-world practice of transcatheter MV therapies targeting especially elderly patients, the surgical community is asked to offer a valuable, effective, and safe treatment option for these “frail” patients, one with a low operational risk and a virtually lifelong duration. 2 3 4 5 Furthermore, only few reports and case series have focused on contemporary results of modern miMVS in elderly patients; 6 7 instead, most of the previous literature on MV surgery involved a comparison of minimally invasive and full-sternotomy procedures, 8 9 10 which may not adequately represent contemporary outcomes of miMVS. In this context, the aim of this study was to analyze whether age ≥75 years affected early postoperative outcomes in miMVS.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Mitral Valve Surgery in the Elderly

Franz

Manna

Schulz

et al. 2023

Thorac Cardiovasc Surg

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Background The minimally invasive mitral valve procedure warrants minimal surgical trauma and might influence the postoperative course positively, especially in old patients. In this retrospective study, we reviewed our experience in minimally invasive mitral valve surgery (miMVS) in patients aged ≥ 75 years. Methods In this retrospective cohort study, based on propensity score matching, we compared patients aged ≥75 years with patients aged <75 years who underwent miMVS. The primary endpoint was 30-day mortality. Secondary endpoints were myocardial infarction, stroke, and renal failure. Results Between January 2011 and February 2021, 761 patients underwent miMVS at our institution. After propensity score matching, a study group (≥75 years, n = 189) and a control group (<75 years, n = 189) were formed. Preoperatively patients ≥75 years more often suffered from NYHA III heart failure (60 vs. 46%; p = 0.013). Their valves were more often frequently replaced (48 vs. 32%; p < 0.001), and their postoperative ventilation time was longer (13 hours vs. 11 hours; p < 0.001). There were no statistically significant differences regarding postoperative stroke (3 vs. 0.6%; p = 0.16), myocardial infarction (0 vs. 1%; p = 0.32), renal insufficiency with new dialysis (5 vs. 4%; p = 0.62), and 30-day mortality (4 vs. 2%; p = 0.56). Conclusion miMVS results in satisfactory early postoperative outcomes in elderly patients.

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338 * Transcatheter Mitral Valve Implantation via Transapical Approach: Early Experience

Cited by 2 publications

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CT Planning prior to Transcatheter Mitral Valve Replacement (TMVR)

CT Planning prior to Transcatheter Mitral Valve Replacement (TMVR)

Minimally Invasive Mitral Valve Surgery in the Elderly

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