Edge-to-edge mitral valve repair: the Columbia Presbyterian experience

Kherani, Aftab R.; Cheema, Faisal H.; Casher, Jennifer; Fal, Jennifer M; Mutrie, Christopher J.; Chen, Jonathan M.; Morgan, Jeffrey A.; Vigilance, Deon W.; Garrido, Mauricio; Smith, Craig R.; Öz, Mehmet C.

doi:10.1016/j.athoracsur.2003.08.085

Cited by 61 publications

(29 citation statements)

References 11 publications

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“…The increase in body size associated with normal growth in children places greater demands on the heart, so we use Alfieli's methods, which allow for valvular growth with age, instead of using valvular ring annuloplasty. [11][12][13] However, the longer-term outcomes after the procedure are still largely unknown. [4][5][6][7]10 MVR is another option for cases of DCM with severe MR, [20][21][22] To a greater or lesser degree, MR coexists with severe DCM and the mechanism of MR is considered to involve tethering of the mitral leaflet by the papillary muscles, with dilatation of the mitral annulus.…”

Section: Discussionmentioning

confidence: 99%

“…The as much myocardium as possible is resected from the posterolateral wall between the 2 papillary muscles, followed by Alfieli's mitral valve repair. 7,[10][11][12][13] Indications for MVR were: (1) more than moderate MR with a severely dilated left atrium on echocardiography; (2) >10% FS or >25% EF on echocardiography; (3) >1,000 pg/ml BNP, and (4) previous mitral repair (Alfieri procedure) or coexisting mitral stenosis. All the criteria had to be fulfilled.…”

Section: Surgical Interventionsmentioning

confidence: 99%

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Outcome of Non-Transplant Surgical Strategy for End-Stage Dilated Cardiomyopathy in Young Children

Sugiyama

Hoshiai

Naitoh

et al. 2009

Circ J

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Background:The shortage of heart transplantation donors is a problem, but partial left ventriculectomy (PLV) and mitral valve replacement (MVR) are feasible at the optimal timing, even in young children. Methods and Results: From May 1998 to May 2008, 11 children under the age of 3 years were diagnosed with severe dilated cardiomyopathy (DCM). Indications and outcomes of non-transplant surgical strategies were evaluated and 8 procedures were performed in 6 children: 5 PLV and 3 MVR. Two of them underwent MVR after PLV because of deterioration of mitral regurgitation (MR). Age at surgery ranged from 8 months to 2 years 11 months. Four are alive, of whom 1 eventually underwent a heart transplant overseas. Two children died during the study period: 1 who underwent only MVR died of intracranial bleeding during thrombolytic therapy for a thrombus stack valve and the other child died of congestive heart failure because of progressive MR 2 months after PLV. Follow-up after PLV ranged from 2 months to 8 years, and after MVR ranged from 1 month to 4 years. Conclusions: PLV and MVR are feasible and effective and should be considered when heart failure resists conventional therapy. (Circ J 2009; 73: 1045 -1048

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Interventionsmentioning

confidence: 99%

Outcome of Non-Transplant Surgical Strategy for End-Stage Dilated Cardiomyopathy in Young Children

Sugiyama

Hoshiai

Naitoh

et al. 2009

Circ J

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“…80,81 The Alfieri technique is typically used with other repair techniques and an annuloplasty, because results when used without an annuloplasty have been suboptimal, with recurrent MR and a high risk for reoperation (11% overall, 23% for those with annular calcification versus 5% without calcification, at a mean follow-up of 2.9 years), in Alfieri's experience. [81][82][83] These approaches are not without potential problems. Artificial chords may be left too long, which results in residual prolapse, or made too short, which leads to restriction of the leaflet and residual MR.…”

Section: Edge-to-edge Approximation (Alfieri Repair) and Artificial Cmentioning

confidence: 99%

Evolving Concepts and Technologies in Mitral Valve Repair

Fedak

McCarthy

Bonow³

2008

Circulation

154

109

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“…43,44 It has been used as a bail-out procedure in cases of both functional and degenerative MR when more conventional surgical approaches had suboptimal outcomes. Isolated edge-to-edge surgical repair in a patient cohort with optimal leaflet morphology had 90% freedom from reoperation and recurrent MR Ͼ2ϩ at 5 years, and almost 80% freedom from reoperation and recurrent MR Ͼ2ϩ after 12 years.…”

Section: Transcatheter Mitral Valve Therapies Leaflet Repairmentioning

confidence: 99%

Prospects for Percutaneous Valve Therapies

Feldman

Leon

2007

Circulation

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D evelopmental efforts to achieve percutaneous catheterbased therapies for cardiac valve repair and replacement have advanced rapidly over the past several years. A variety of methods to treat mitral regurgitation (MR) and to replace aortic and pulmonic valves have already been successfully employed in patients. These innovative clinical transcatheter valve therapies were anticipated more than a decade ago by creative experimentalists who helped develop predicate techniques in animal models. For example, in 1992, a catheterdelivered ball-in-cage prosthetic aortic valve was implanted in a canine model by Pavcnik 1 and a stent-mounted bioprosthetic valve was placed by Andersen, who used a retrograde transarterial approach in a swine model. 2 Clearly, the catheter-based technologies used in clinical studies today in patients with aortic stenosis were derived from the fusion of known successful aortic valve replacement (AVR) surgical devices and adaptive interventional modalities, first studied in experimental animal models. Similarly, approaches for transcatheter treatment of MR have also borrowed heavily from preexisting and accepted surgical techniques, such as the edge-to-edge leaflet coaptation technique and reduction ring mitral annuloplasty. 3 Importantly, recognition that the coronary sinus parallels the mitral annulus has spurred unique catheter-based transvenous approaches to treat MR by indirectly reducing mitral annular dimensions. 4 Because many of the new percutaneous approaches to valve therapy have been developed by surgeons, a collaboration has emerged between thoughtful surgeons and interventionalists, combining skill sets and experiences to accelerate the developmental pathways of less-invasive transcatheter valve therapies.

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Edge-to-edge mitral valve repair: the Columbia Presbyterian experience

Cited by 61 publications

References 11 publications

Outcome of Non-Transplant Surgical Strategy for End-Stage Dilated Cardiomyopathy in Young Children

Outcome of Non-Transplant Surgical Strategy for End-Stage Dilated Cardiomyopathy in Young Children

Evolving Concepts and Technologies in Mitral Valve Repair

Prospects for Percutaneous Valve Therapies

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