Mitral Valve Annuloplasty Failure and Percutaneous Treatment Options
| Autor: | Kara M. Joseph, Charles B. Nyman |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cardiac Catheterization Percutaneous Mitral Valve Annuloplasty medicine.medical_treatment Heart Valve Diseases Mitral valve Mitral valve annuloplasty medicine Ventricular outflow tract Humans cardiovascular diseases Heart Valve Prosthesis Implantation Mitral valve repair Mitral regurgitation business.industry MitraClip Mitral valve replacement Mitral Valve Insufficiency Surgery medicine.anatomical_structure Treatment Outcome cardiovascular system Mitral Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | Current cardiology reports. 23(10) |
| ISSN: | 1534-3170 |
| Popis: | Mitral valve repair is a common surgical procedure for both primary and secondary mitral regurgitation. With operations performed earlier in disease progression and increased patient longevity, the need for a repeat intervention is not infrequent. With the associated risks of reoperation and patient comorbidities, percutaneous techniques for acute or delayed failure after ring annuloplasty are emerging. Current commercially available devices, used in “off-label” ways, such as the MitraClip, may be effective in repairing recurrent mitral regurgitation after annuloplasty. Similarly, a valve-in-ring transcatheter mitral valve replacement can be considered in patients at high risk for surgical reoperation. These procedures are not without risk, for example, resultant mitral stenosis in the setting of edge-to-edge repair or left ventricular outflow tract (LVOT) obstruction with valve-in-ring transcatheter mitral valve replacement. Newer devices are emerging to permit more options for this subset of patients, which include transcatheter valves that are specifically designed for the mitral position. Undoubtedly, surgical reoperation has increased risk as compared to primary operation. Though percutaneous options are evolving, use in this patient population is currently limited to “off-label” use and is also associated with procedural complexities and risk. It is prudent for cardiologists, surgeons, and anesthesiologists to weigh risks, benefits, and limitations when considering patients for surgical reoperation, percutaneous repair, or transcatheter replacement after failed mitral annuloplasty. |
| Databáze: | OpenAIRE |
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