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Transcatheter Mitral Valve Replacement for Treating Native Mitral Valve Disease: Current Status
Yan Chen1, Junjie Hu1, Shunqiang Wu1
1Department of Thoracic Cardiovascular Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China.
Texas Heart Institute Journal
|January 20, 2021
Summary
Transcatheter mitral valve replacement is feasible for native mitral valve disease. Transapical access shows greater reliability than transseptal access, though secure valve anchoring remains a challenge.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Transcatheter mitral valve replacement (TMVR) is emerging for high-risk patients with native mitral valve disease.
- Comprehensive effectiveness data for TMVR in native disease is limited.
Purpose of the Study:
- To evaluate the effectiveness and outcomes of transcatheter mitral valve replacement in patients with native mitral valve disease.
- To compare different transcatheter access routes and their impact on procedural success.
Main Methods:
- Literature search for case reports of TMVR in native mitral valve disease (September 2013 - April 2017).
- Analysis of 66 patients from 40 reports, documenting baseline characteristics, procedural details, and outcomes.
- Comparison of transapical versus transseptal access methods.
Main Results:
- The 30-day survival rate was 82.5% across 66 patients.
- Overall technical success rate was 83.3%, with a trend towards higher success in mitral regurgitation compared to mitral stenosis.
- Transapical access was associated with fewer valve-in-valve implantations than transseptal access (P=0.026).
Conclusions:
- Transcatheter mitral valve replacement is a feasible treatment option for native mitral valve disease.
- Transapical access appears more reliable than transseptal access for TMVR.
- Improved valve anchoring systems are needed, particularly for transseptal approaches in mitral stenosis.
Keywords:
Disease-free survivalheart valve prosthesis implantation/methodsmitral valve insufficiency/physiopathologymitral valve stenosis/therapypostoperative complications/etiologyrecovery of functionretrospective studiessurvival ratetranscatheter mitral valve replacement/methodstreatment outcomeMore Related Videos
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