Commentary: From bailout to standardized approach in mitral annulus calcification: It's a short step

Formica, Francesco

doi:10.1016/j.xjtc.2021.09.003

Cited by 1 publication

(1 citation statement)

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“…Mortality at the one-year follow-up is high (around 50%), underscoring the importance of patient selection and of performing these interventions in experienced centers. When comparing the three approaches of TMVR for ViMAC, transatrial appears to have the best results, with one-year rates of mortality at 35% (25% in the latest series) [ 16 , 22 , 23 ], compared to those of transapical (57%) and transseptal (63%), and higher technical success rates (89% vs. 71% and 65%, respectively). The most important adverse event is the obstruction of the LVOT, with a hazard ratio for mortality of 2.87 (95% confidence interval 1.66–4.96) [ 19 ], so this must always be anticipated by a preprocedural CT. An area below 170 mm 2 in the LVOT once the valve is implanted (“neo-LVOT”) is highly predictive of this complication ( Figure 6 ) [ 13 ].…”

Section: Lithotripsy-facilitated Percutaneous Mitralmentioning

confidence: 99%

New Percutaneous Approaches for the Treatment of Heavily Calcified Mitral Valve Stenosis

Sanz‐Ruiz

Vázquez-Álvarez

Gutiérrez‐Ibañes

et al. 2022

JCM

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Important breakthroughs have considerably improved the outcomes of the percutaneous treatment of valvular heart diseases during the last decades. However, calcium deposition and progressive calcification of the left-sided heart valves present a challenge with prognostic implications that have not been addressed until recently. In the case of native mitral stenosis with no surgical options, a compelling need for tackling heavily calcified valves has led to the development of novel debulking techniques and to the use of aortic balloon-expandable bioprosthesis in the mitral position. In this section of the special issue “Mitral Valve Disease: State of the Art”, we will review standard approaches and indications for the treatment of native mitral stenosis; summarize these two innovative solutions and their evidence, describing both procedures in a “step-by-step” fashion; and briefly comment on future directions in this field.

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