Transcatheter mitral valve implantation versus conventional redo surgery for degenerated mitral valve prostheses and rings in a multicenter registry

Szłapka, Michał; Hausmann, Harald; Timm, Jürgen; Bauer, Adrian; Metz, D; Pohling, Daniel; Fritzsche, Dirk; Gyoten, Takayuki; Kuntze, Thomas; Dörge, Hilmar; Feyrer, R.; Brambate, Agrita; Sodian, Ralf; Buchholz, Stefan; Sack, FU; Höhn, Martina; Fischlein, Theodor; Eichinger, Walter; Franke, Ulrich; Nagib, Ragi

doi:10.1016/j.jtcvs.2022.07.032

Cited by 7 publications

(2 citation statements)

References 20 publications

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“…The incidence of perivalvular leakage was higher in patients with TMVR, which is consistent with findings reported in previous studies ( 12 ). Murzi et al ( 7 ) reported the results of transapical TMVR versus redo SMVR; they showed that 28% of patients in the TMVR group had less than mild perivalvular leakage, compared with none of the patients in the SMVR group.…”

Section: Discussionsupporting

confidence: 92%

Transcatheter mitral valve replacement versus redo surgery for mitral prosthesis failure: A systematic review and meta-analysis

Zhou

Chen

et al. 2023

Front. Cardiovasc. Med.

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BackgroundTranscatheter mitral valve replacement (TMVR) has emerged as an alternative to redo surgery. TMVR compared with redo surgical mitral valve replacement (SMVR) in patients with mitral prosthesis failure remains limited. In this study, we performed a meta-analysis to assess the outcomes of TMVR (including valve-in-valve and valve-in-ring) versus redo surgery for mitral prosthesis failure.MethodsWe comprehensively searched the PubMed, Embase, and Cochrane library databases according to predetermined inclusion and exclusion criteria, and then we extracted data. We compared the outcomes of TMVR and redo SMVR for mitral prosthesis failure in terms of the in-hospital mortality, stroke, renal dysfunction, vascular complication, pacemaker implantation, exploration for bleeding, paravalvular leak, mean mitral valve gradient, 30-day mortality, and 1-year mortality.ResultsNine retrospective cohort studies and a total of 3,038 patients were included in this analysis. Compared with redo SMVR for mitral prosthesis failure, TMVR was associated with lower in-hospital mortality [odds ratios (OR): 0.44; 95% confidence interval (CI): 0.30–0.64; P < 0.001], stroke (OR: 0.44; 95% CI: 0.29–0.67; P = 0.0001), renal dysfunction (OR: 0.52; 95% CI: 0.37–0.75; P = 0.0003), vascular complication (OR: 0.58; 95% CI: 0.43–0.78; P = 0.004), pacemaker implantation (OR: 0.23; 95% CI: 0.15–0.36; P < 0.00001), and exploration for bleeding (OR: 0.24; 95% CI: 0.06–0.96; P = 0.04). Conversely, redo SMVR had lower paravalvular leak (OR: 22.12; 95% CI: 2.81–174.16; P = 0.003). There was no difference in mean mitral valve gradient (MD: 0.04; 95% CI: −0.47 to 0.55; P = 0.87), 30-day mortality (OR: 0.65; 95% CI: 0.36–1.17; P = 0.15), and 1-year mortality (OR: 0.96; 95% CI: 0.63–1.45; P = 0.84).ConclusionIn patients with mitral prosthesis failure, TMVR is associated with lower in-hospital mortality and lower occurrence of postoperative complications, except for paravalvular leak. TMVR offers a viable alternative to the conventional redo surgery in selected patients.

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Section: Discussionsupporting

confidence: 92%

Transcatheter mitral valve replacement versus redo surgery for mitral prosthesis failure: A systematic review and meta-analysis

Zhou

Chen

et al. 2023

Front. Cardiovasc. Med.

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“…Additionally, in contrast to transcatheter approaches, redo surgery enables treatment of concomitant conditions, such as atrial fibrillation or tricuspid valve regurgitation. Furthermore, there is no significant difference in mortality between redo MVS and valve-in-valve procedures [ 16 , 17 ]. Finally, transcatheter MV-in-ring procedures have been associated with disappointing results [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Early and long-term outcomes following redo mitral valve surgery in patients with prior minimally invasive mitral valve surgery

Schumacher,

Marin Cuartas,

de la Cuesta

et al. 2024

Interdisciplinary CardioVascular and Thoracic Surgery

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OBJECTIVES The frequency of minimally invasive mitral valve surgery has steadily increased over the last decades and therefore surgeons are now encountering an increasing number of patients requiring mitral valve reoperations post-minimally invasive mitral valve surgery. The aim of this study was to analyze the early postoperative outcomes and the long-term survival in patients who undergo reoperative mitral valve surgery following previous minimally invasive surgery. METHODS Patients who underwent redo mitral valve surgery following prior minimally invasive mitral valve surgery between January 2002 and December 2021 were included in our analysis. Study data were prospectively collected and retrospectively analyzed. The primary outcomes were 30-day mortality and long-term survival. RESULTS Among the 187 included patients, 34 (18.2%) underwent repeat mitral valve repair and 153 (81.8%) mitral valve replacement. Median age was 66 years (Interquartile range 56—74) and 80 (42.8%) patients were female. Redo mitral valve surgery was performed through median sternotomy in 169 patients (90.4%). A total of 77 (41.2%) patients had additional concomitant procedures. Median ICU stay was 1 day (1—5). The 30-day mortality was 6.4% (12/187). Estimated survival at 5 and 12 years was 61.8% and 38.3%, respectively. Preoperative stroke (HR 3.28, 95% CI 1.37–7.85, p = 0.007) as well as infective endocarditis (HR 1.85; 95% CI 1.09-3.11, p = 0.021) were independent predictors of long-term mortality. CONCLUSIONS Redo mitral valve surgery following prior minimally invasive mitral valve surgery can be performed safely with low early perioperative mortality and acceptable long-term survival. Preoperative stroke, infective endocarditis and concomitant tricuspid valve surgery are independent predictors of long-term mortality.

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Simultaneous transapical transcatheter aortic and mitral valve replacement in patients with severe valve dysfunction: initial experience

Zhou,

Li,

Wang

et al. 2024

Gen Thorac Cardiovasc Surg

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Transcatheter mitral valve implantation versus conventional redo surgery for degenerated mitral valve prostheses and rings in a multicenter registry

Cited by 7 publications

References 20 publications

Transcatheter mitral valve replacement versus redo surgery for mitral prosthesis failure: A systematic review and meta-analysis

Transcatheter mitral valve replacement versus redo surgery for mitral prosthesis failure: A systematic review and meta-analysis

Early and long-term outcomes following redo mitral valve surgery in patients with prior minimally invasive mitral valve surgery

Simultaneous transapical transcatheter aortic and mitral valve replacement in patients with severe valve dysfunction: initial experience

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