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Transcatheter Mitral Valve Replacement in Native Mitral Valve Disease With Severe Mitral Annular Calcification:

Mayra Guerrero1, Danny Dvir2, Dominique Himbert3

  • 1Department of Medicine, Division of Cardiology, Evanston Hospital, Evanston, Illinois.

JACC. Cardiovascular Interventions
|July 9, 2016
PubMed

Insights

Transcatheter mitral valve replacement (TMVR) using balloon-expandable valves is feasible for severe mitral annular calcification (MAC). While associated with adverse events, it offers an alternative for high-risk patients.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Devices

Background:

  • Surgical mitral valve replacement carries high risks for patients with severe mitral annular calcification (MAC).
  • Transcatheter mitral valve replacement (TMVR) with balloon-expandable valves shows promise in isolated reports for this challenging patient group.

Purpose of the Study:

  • To evaluate the outcomes of early transcatheter mitral valve replacement (TMVR) experiences.
  • To assess the use of balloon-expandable valves in patients with severe mitral annular calcification (MAC).
  • To report findings from the first large, multicenter global registry on this topic.

Main Methods:

  • A multicenter retrospective review was conducted.
  • Clinical outcomes of patients with severe MAC undergoing TMVR were analyzed.
  • Data were collected from September 2012 to July 2015 across 32 centers.

Main Results:

  • 64 patients with severe MAC underwent TMVR using balloon-expandable valves.
  • Technical success was achieved in 72% of patients; 9.3% experienced left ventricular tract obstruction.
  • Thirty-day all-cause mortality was 29.7%, with 84% of survivors in NYHA class I or II.

Conclusions:

  • Transcatheter mitral valve replacement (TMVR) with balloon-expandable valves is feasible in severe mitral annular calcification (MAC).
  • The procedure is linked to significant adverse events, necessitating careful patient selection.
  • This approach may serve as a viable alternative for select high-risk individuals with limited options.
Abstract

Keywords:
calcific mitral stenosismitral annular calcificationmitral valve diseasemitral valve replacementtranscatheter valve replacement

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