1. Novel Transcatheter Mitral Valve Prosthesis for Patients With Severe Mitral Annular Calcification.
- Author
-
Sorajja, Paul, Gössl, Mario, Babaliaros, Vasilis, Rizik, David, Conradi, Lenard, Bae, Richard, Burke, Robert F., Schäfer, Ulrich, Lisko, John C., Riley, Robert D., Guyton, Robert, Dumonteil, Nicolas, Berthoumieu, Pierre, Tchetche, Didier, Blanke, Philipp, Cavalcante, João L., and Sun, Benjamin
- Subjects
- *
VENTRICULAR outflow obstruction , *MITRAL valve , *CALCIFICATION , *TRANSESOPHAGEAL echocardiography , *PROSTHETICS , *MITRAL valve insufficiency - Abstract
Background: Treatment of mitral regurgitation (MR) in the setting of severe mitral annular calcification (MAC) is challenging due to the high risk for fatal atrioventricular groove disruption and significant paravalvular leak.Objectives: The objective of this study was to evaluate the potential for transcatheter mitral valve replacement in patients with severe MAC using an anatomically designed mitral prosthesis.Methods: Nine patients (77 ± 6 years of age; 5 men) were treated with the valve, using transapical delivery performed under general anesthesia and with guidance from transesophageal echocardiography and fluoroscopy.Results: Device implantation was successful with relief of MR in all 9 patients. There were no procedural deaths. In 1 patient, left ventricular outflow tract obstruction occurred due to malrotation of the prosthesis, and successful alcohol septal ablation was performed. During a median follow-up of 12 months (range 1 to 28 months), there was 1 cardiac death, 1 noncardiac death, no other mortality, and no prosthetic dysfunction, and MR remained absent in all treated patients. Rehospitalization for heart failure occurred in 2 patients who did not die subsequently. Clinical improvement with mild or no symptoms occurred in all patients alive at the end of follow-up.Conclusions: Transcatheter mitral valve replacement in severe mitral annular calcification with a dedicated prosthesis is feasible and can result in MR relief with symptom improvement. Further evaluation of this approach for these high-risk patients is warranted. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF