First-in-Human Off-Pump Transcatheter Mitral Valve Replacement

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

“…6 It is thought that the D-shaped approach is a better representation of the cross-sectional area of current TMVs under investigation, D-Shaped Mitral Annulus in Transcatheter Implants including the Tiara 10 and Tendyne valves. 11 Additionally, a TMVI encroaching beyond the intertrigonal line would likely result in left ventricular outflow tract obstruction.…”

First-in-Human Case of Transfemoral CardiAQ Mitral Valve Implantation

“…Interestingly, these challenges have been addressed in different ways, for example, by introducing a D-shaped stent design, annular versus apical anchoring, or a large inflow sealing area. [1][2][3][4] Also the CardiAQ prosthesis has been optimized since its first implant, as described in this report. The second-generation CardiAQ valve is built on the company's proprietary method for anchoring the implant through leaflet engagement, chordal preservation, and annular attachment, while offering improved flow properties and a novel feature for the prevention of paravalvular leaks.…”

“…This study will enroll ≤20 patients and will involve both the transfemoral (n=10) and TA (n=10) TMVI systems. Also Neovasc Inc (Tiara valve), 2 Tendyne Inc (Tendyne valve), 3 and Edwards LifeSciences (Fortis valve) 4 performed their first-inhuman TA-TMVI procedures in 2014 and recently received Food and Drug Administration approval for early feasibility trials, indicating that the TMVI technology has reached a new stage in its development.…”

Transcathether Valve Replacement and Valve Repair

“…Nonetheless, transcatheter mitral valve replacement may be a future option in patients with advanced mitral valve disease deemed high or prohibitive risk for surgery. 99,[101][102][103][104][105][106] The mitral valve has numerous anatomic considerations that make transcatheter valve design more complicated than the AV: a complex and dynamic mitral annular geometry, an asymmetrical bileaflet anatomy, left ventricular interaction through papillary muscles and attached chordae, and continuity between the mitral inflow and aortic outflow. In addition, unlike for valve-in-mitral annular calcification, there is no calcified anchoring structure, and the closing forces on the mitral valve (ie, ventricular systolic pressure) are greater than the systolic or diastolic force on the AV.…”