The Trans-Septal Approach In Transcatheter Mitral Valve-In-Valve Implantation For Degenerative Bioprosthesis
| Autor: | Amr A. Arafat, Abdullah Alkhushail, Monirah A Albabtain, Turki Al Garni, Mohammed Al Otaiby, Abdulrahman Almoghairi, Sondos Samargandy, Hussein S. Alamri |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Hemodynamics Permanent pacemaker insertion Prosthesis Nyha class Surgery Cardiac surgery medicine.anatomical_structure Mitral valve cardiovascular system Risk of mortality Medicine cardiovascular diseases Tamponade Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the Saudi Heart Association. 32:141-148 |
| ISSN: | 2212-5043 |
| DOI: | 10.37616/2212-5043.1036 |
| Popis: | Background Transcatheter Mitral Valve-in-Valve Implantation (TMViVI) has recently emerged as a novel therapy for degenerated mitral valve bioprosthesis. Re-operative mitral valve surgery is associated with a substantial risk of mortality and morbidity. The objective of this study was to describe the outcomes of transcatheter mitral valve-in-valve implantations in our cardiac center. Methods Twenty-two patients underwent the valve-in-valve procedure because of bioprosthesis degeneration from March 2017 to October 2018. Clinical, echocardiographic, procedural details and survival at follow up were assessed. Results Eight patients refused re-operative cardiac surgery while others were deemed a high risk for conventional re-operative sternotomy. All patients had TMViVI performed via a trans-septal approach, and the prosthesis was implanted successfully with immediate hemodynamic improvement in 20 patients. One patient had tamponade (4.55%), two had permanent pacemaker insertion (9.09%), two patients had a renal impairment (9.09%), and three patients had vascular complications (13.64%). There was one aborted procedure for the failure to cross the tissue valve with a transcatheter valve, and one patient was converted to an emergency mitral valve surgery. All patients were discharged in NYHA class I/II and NYHA class was markedly improved at one-year follow-up (p = 0.002). Conclusions Trans-septal mitral valve-in-valve implantation can be performed safely for degenerative mitral valve bioprosthesis and with favorable early clinical and hemodynamic outcomes. |
| Databáze: | OpenAIRE |
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