The trans-septal approach in transcatheter mitral valve-in-valve implantation for degenerative bioprosthesis

Autor: Mohammed Al, Otaiby, Turki A, Al Garni, Abdullah, Alkhushail, Abdulrahman, Almoghairi, Sondos, Samargandy, Monirah, Albabtain, Khaled D, Algarni, Amr A, Arafat, Hatim, Khairallah, Hussein, Alamri
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of the Saudi Heart Association
ISSN: 2212-5043
1016-7315
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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