Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes
Background: In specific patients with severe mitral regurgitation (MR), mitral valve (MV) pathology is unique and requires creative transcatheter repair techniques. This study aimed to evaluate the feasibility and safety of a new transcatheter MV repair technique, using occluder devices in symptomat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-07-01
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| Series: | Structural Heart |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2474870622018097 |
| _version_ | 1818066502068207616 |
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| author | Fatma Aboalsoud Taha, MD Hesham Naeim, MD Osama Amoudi, MD Fareed Alnozha, MD Mansour Almutairi, MD Reda Abuelatta, MD |
| author_facet | Fatma Aboalsoud Taha, MD Hesham Naeim, MD Osama Amoudi, MD Fareed Alnozha, MD Mansour Almutairi, MD Reda Abuelatta, MD |
| author_sort | Fatma Aboalsoud Taha, MD |
| collection | DOAJ |
| description | Background: In specific patients with severe mitral regurgitation (MR), mitral valve (MV) pathology is unique and requires creative transcatheter repair techniques. This study aimed to evaluate the feasibility and safety of a new transcatheter MV repair technique, using occluder devices in symptomatic high-surgical-risk patients with severe MR, either due to MV leaflet (MVL) perforations or due to post-clips residual MR, and to report on their 6-month outcomes. Methods: The study enrolled all high-risk patients with severe MR due to MVL perforations and post-clips residual MR who underwent transcatheter MV repair using occluder devices, from November 2016 to August 2019. Results: The study enrolled 16 patients; 9 (56.25%) with MVL perforations and 7 (43.75%) with post-MitraClip (Abbott Laboratories, Abbott Park, Illinois) residual MR, with a mean age of 55.75 ± 16.69 years. Mean perforation/jet diameters were 5.75 ± 1.67 and 6.5 ± 1.93 mm, and the mean 3D-vena contracta area was 0.54 ± 0.14 cm2. Perforations were crossed retrograde (transaortic in 7 [43.75%] patients and transapical in 2 [12.5%] patients), and post-MitraClip devices residual jets were crossed antegrade (transvenous/transseptal). Six (37.5%) patients required arteriovenous loop formation for device deployment, that was antegrade transvenous/transseptal in 13 (81.25%) patients and retrograde transapical in 3 (18.75%) patients. Devices used were Amplatzer-ASO in 10 (62.5%) patients and Amplatzer-VP-II in 6 (37.5%) patients. Mean procedural and fluoroscopy times were 55.13 ± 16.24 and 16.25 ± 4.03 minutes, respectively. Patients passed successfully, without MV gradient change or device-related complications. Conclusions: Transcatheter MV repair of MVL perforations/post-clips residual MR is a new, feasible, and safe technique for high-surgical-risk patients. |
| first_indexed | 2024-12-10T15:08:48Z |
| format | Article |
| id | doaj.art-93a137a90fa646259fb5de786efc14b4 |
| institution | Directory Open Access Journal |
| issn | 2474-8706 |
| language | English |
| last_indexed | 2024-12-10T15:08:48Z |
| publishDate | 2022-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Structural Heart |
| spelling | doaj.art-93a137a90fa646259fb5de786efc14b42022-12-22T01:43:59ZengElsevierStructural Heart2474-87062022-07-0163100043Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and OutcomesFatma Aboalsoud Taha, MD0Hesham Naeim, MD1Osama Amoudi, MD2Fareed Alnozha, MD3Mansour Almutairi, MD4Reda Abuelatta, MD5Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia; Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Address correspondence to: Fatma Aboalsoud Taha, MD, Assistant Professor and Consultant of Cardiology and Congenital Heart Disease, Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Consultant of Cardiology and Adult Congenital Heart Disease, Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi ArabiaAdult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi ArabiaAdult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi ArabiaAdult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi ArabiaAdult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi ArabiaAdult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi ArabiaBackground: In specific patients with severe mitral regurgitation (MR), mitral valve (MV) pathology is unique and requires creative transcatheter repair techniques. This study aimed to evaluate the feasibility and safety of a new transcatheter MV repair technique, using occluder devices in symptomatic high-surgical-risk patients with severe MR, either due to MV leaflet (MVL) perforations or due to post-clips residual MR, and to report on their 6-month outcomes. Methods: The study enrolled all high-risk patients with severe MR due to MVL perforations and post-clips residual MR who underwent transcatheter MV repair using occluder devices, from November 2016 to August 2019. Results: The study enrolled 16 patients; 9 (56.25%) with MVL perforations and 7 (43.75%) with post-MitraClip (Abbott Laboratories, Abbott Park, Illinois) residual MR, with a mean age of 55.75 ± 16.69 years. Mean perforation/jet diameters were 5.75 ± 1.67 and 6.5 ± 1.93 mm, and the mean 3D-vena contracta area was 0.54 ± 0.14 cm2. Perforations were crossed retrograde (transaortic in 7 [43.75%] patients and transapical in 2 [12.5%] patients), and post-MitraClip devices residual jets were crossed antegrade (transvenous/transseptal). Six (37.5%) patients required arteriovenous loop formation for device deployment, that was antegrade transvenous/transseptal in 13 (81.25%) patients and retrograde transapical in 3 (18.75%) patients. Devices used were Amplatzer-ASO in 10 (62.5%) patients and Amplatzer-VP-II in 6 (37.5%) patients. Mean procedural and fluoroscopy times were 55.13 ± 16.24 and 16.25 ± 4.03 minutes, respectively. Patients passed successfully, without MV gradient change or device-related complications. Conclusions: Transcatheter MV repair of MVL perforations/post-clips residual MR is a new, feasible, and safe technique for high-surgical-risk patients.http://www.sciencedirect.com/science/article/pii/S2474870622018097Mitral valve leaflet perforationPost-clips residual mitral regurgeTranscatheter mitral valve regurgitation repair |
| spellingShingle | Fatma Aboalsoud Taha, MD Hesham Naeim, MD Osama Amoudi, MD Fareed Alnozha, MD Mansour Almutairi, MD Reda Abuelatta, MD Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes Structural Heart Mitral valve leaflet perforation Post-clips residual mitral regurge Transcatheter mitral valve regurgitation repair |
| title | Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes |
| title_full | Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes |
| title_fullStr | Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes |
| title_full_unstemmed | Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes |
| title_short | Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes |
| title_sort | transcatheter mitral valve repair technique in specific severe mitral regurgitation tips tricks and outcomes |
| topic | Mitral valve leaflet perforation Post-clips residual mitral regurge Transcatheter mitral valve regurgitation repair |
| url | http://www.sciencedirect.com/science/article/pii/S2474870622018097 |
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