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Future Technology.

Kelly Kohorst1, Mias Pretorius1

  • 11 Vanderbilt University Medical Center, Nashville, TN, USA.

Seminars in Cardiothoracic and Vascular Anesthesia
|June 14, 2018
PubMed
Summary

Transcatheter mitral valve repair and replacement offer new minimally invasive options for patients with mitral regurgitation, particularly the elderly and high-risk individuals. Numerous devices targeting leaflets, annulus, and chordae tendineae are in development and clinical trials.

Keywords:
beating heart surgerymitral valve repairmitral valve replacementtranscatheter

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Mitral regurgitation is the most prevalent valvular heart disease, affecting 2.3% of individuals over 65.
  • Conventional open-heart surgery poses high risks for many patients with mitral valve disease.
  • The mitral valve's complex anatomy presents unique challenges for transcatheter interventions compared to the aortic valve.

Purpose of the Study:

  • To review the current landscape of transcatheter technologies for mitral valve disease.
  • To highlight devices targeting mitral regurgitation via leaflets, annulus, and chordae tendineae.
  • To discuss the potential future of minimally invasive mitral valve treatments.

Main Methods:

  • Review of existing and investigational transcatheter devices for mitral valve repair and replacement.
  • Analysis of devices targeting different mitral valve components (leaflets, annulus, chordae tendineae).
  • Examination of delivery approaches (transseptal, transapical, transaortic, left atriotomy).

Main Results:

  • The MitraClip is the sole FDA-approved device for mitral regurgitation, targeting leaflets.
  • Eight minimally invasive devices targeting the mitral annulus are under human study.
  • Five devices for chordae tendineae repair are in clinical trials, with over 10 transcatheter mitral valves in development.

Conclusions:

  • Transcatheter approaches are rapidly evolving for mitral valve disease.
  • These minimally invasive options show promise, especially for high-risk and elderly patient populations.
  • The future likely involves increased adoption of transcatheter treatments for mitral valve conditions.