Transcatheter Mitral Valve Replacement for Treating Native Mitral Valve Disease: Current Status.

Publisher: published in the Cardiovascular Surgical Research Laboratories, Texas Heart Institute Country of Publication: United States NLM ID: 8214622 Publication Model: Print Cited Medium: Internet ISSN: 1526-6702 (Electronic) Linking ISSN: 07302347 NLM ISO Abbreviation: Tex Heart Inst J Subsets: MEDLINE

Original Publication: Houston, TX : published in the Cardiovascular Surgical Research Laboratories, Texas Heart Institute, c1982-

Bioprosthesis* ; Heart Valve Prosthesis*; Cardiac Catheterization/*methods ; Heart Valve Diseases/*surgery ; Heart Valve Prosthesis Implantation/*methods ; Mitral Valve/*surgery; Humans ; Prosthesis Design

Transcatheter mitral valve replacement is increasingly being used as a treatment for high-risk patients who have native mitral valve disease; however, no comprehensive studies on its effectiveness have been reported. We therefore searched the literature for reports on patients with native mitral valve disease who underwent transcatheter access treatment. We found 40 reports, published from September 2013 through April 2017, that described the cases of 66 patients (mean age, 71 ± 12 yr; 30 women; 30 patients with mitral stenosis, 34 with mitral regurgitation, and 2 mixed) who underwent transcatheter mitral valve replacement. We documented their baseline clinical characteristics, comorbidities, diagnostic imaging results, procedural details, and postprocedural results. Access was transapical in 41 patients and transseptal in 25. The 30-day survival rate was 82.5%. The technical success rate (83.3% overall) was slightly but not significantly better in patients who had mitral regurgitation than in those who had mitral stenosis. Transapical access procedures resulted in fewer valve-in-valve implantations than did transseptal access procedures (P=0.026). These current results indicate that transcatheter mitral valve replacement is feasible in treating native mitral disease. The slightly higher technical success rate in patients who had mitral regurgitation suggests that a valve with a specific anchoring system is needed when treating mitral stenosis. Our findings indicate that transapical access is more reliable than transseptal access and that securely anchoring the valve is still challenging in transseptal access.
(© 2020 by the Texas Heart® Institute, Houston.)

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Keywords: Disease-free survival; heart valve prosthesis implantation/methods; mitral valve insufficiency/physiopathology; mitral valve stenosis/therapy; postoperative complications/etiology; recovery of function; retrospective studies; survival rate; transcatheter mitral valve replacement/methods; treatment outcome

Date Created: 20210120 Date Completed: 20210906 Latest Revision: 20210906

20250114

PMC7819449

10.14503/THIJ-18-6650

33472225