Hemodynamic and clinical response to transseptal mitral valve-in-valve and valve-in-ring

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
James W LloydMackram F Eleid

Abstract

To understand the clinical and hemodynamic response of patients with stenotic versus regurgitant prosthetic mitral valve degeneration to transseptal transcatheter mitral valve-in-ring/-valve replacement (TMVR). Patients with prosthetic mitral valve repair/replacement failure frequently present high-risk surgical challenges. TMVR has been employed as an alternative to surgery. Forty-four patients with stenotic/regurgitant degeneration of prior prosthetic mitral annuloplasty and replacement (38) underwent mitral TMVR. Clinical, echocardiographic, and invasive hemodynamic monitoring was conducted at baseline and follow-up. Relative to patients with regurgitant degeneration (28), patients with stenotic degeneration had baseline higher mitral valve gradients (12 ± 4 vs. 7 ± 3 mmHg, p < 0.01) and smaller areas (1.0 ± 0.4 vs. 1.5 ± 0.4 cm2 , p = 0.01). TMVR yielded significant reduction in left atrial v-wave pressures in stenotic and regurgitant cohorts (-7 ± 11, p = 0.03, and -11 ± 12 mmHg, p < 0.01, respectively) and significant, sustained symptomatic improvement. Intracardiac pressures overall, including left ventricular end diastolic pressures, remained elevated. Despite baseline differences in valvular disease, TMVR leads to sign...Continue Reading

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Citations

Feb 9, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·James W LloydMackram F Eleid
Sep 18, 2020·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Ali Fatehi HassanabadWilliam D T Kent
Oct 2, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Naoki MisumidaMackram F Eleid

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