Related Experiment Video

Updated: Feb 12, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

2.5K

Transatrial implantation of a transcatheter heart valve for severe mitral annular calcification

Fabien Praz1, Omar K Khalique1, Raymond Lee2

  • 1New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY.

The Journal of Thoracic and Cardiovascular Surgery
|April 9, 2018
PubMed

Insights

Transcatheter heart valve (THV) implantation via the atrium is technically successful for severe mitral annular calcification (MAC). However, this high-risk patient group experienced high 30-day mortality, indicating a need for careful patient selection.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Severe mitral annular calcification (MAC) presents significant challenges for mitral valve repair or replacement.
  • Transcatheter heart valve (THV) technology offers a less invasive option for high-risk patients.

Purpose of the Study:

  • To assess the outcomes of transatrial implantation of a THV for mitral valve disease in patients with severe MAC.
  • To evaluate the technical success and safety of this novel approach.

Main Methods:

  • A balloon-expandable THV was implanted via a transatrial approach under cardiopulmonary bypass.
  • Anterior mitral valve leaflet resection and pledgeted sutures were used to enhance stability and reduce paravalvular leak.
  • Twenty-six high-risk patients with severe MAC were included across six centers.

Main Results:

  • Technical success was achieved in all patients, with a significant reduction in mean transmitral gradient.
  • Post-procedure mitral regurgitation was trace or mild in all patients.
  • Hospital mortality was 19%, and 30-day all-cause mortality was 27%.

Conclusions:

  • Transatrial THV implantation is technically feasible for severe MAC, even with complex anatomy.
  • The early experience in very high-risk patients demonstrated high 30-day mortality.
  • Patients with chronic kidney disease and those undergoing multiple valve surgeries may be at particularly high risk.
Abstract

Keywords:
mitral annular calcificationmitral regurgitationmitral stenosismitral valve surgerytranscatheter valve

More Related Videos

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement09:57

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement

Published on: January 20, 2022

3.2K
A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

4.4K

Related Concept Videos

Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
591
Heart Valves01:16

Heart Valves

The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
12.3K
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
667
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
407
Anatomy of the Heart01:27

Anatomy of the Heart

The human heart is made up of three layers of tissue that are surrounded by the pericardium, a membrane that protects and confines the heart. The outermost layer, closest to the pericardium, is the epicardium. The pericardial cavity separates the pericardium from the epicardium. Beneath the epicardium is the myocardium, the middle layer, and the endocardium, the innermost layer. There are four chambers of the heart: the right atrium, the right ventricle, the left atrium, and the left ventricle.
120.6K
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
744