Aims: Transcatheter mitral valve implantation for mitral valve regurgitation is in the very early phase of development because of challenging anatomy and device dimensions. We describe the procedure of a transfemoral-transseptal implantation of the second-generation CardiAQ™ mitral valve bioprosthesis and 30-day follow-up. Methods and results: The procedure was performed percutaneously, without any left extracorporeal circulatory support. The patient had severe mitral regurgitation with severely depressed ventricular function and other comorbidities. The patient was deemed extreme high risk for conventional cardiac surgery by a multidisciplinary team. The main procedural steps were the creation of an arteriovenous loop with an exchange nitinol wire, and the use of a customised "steerable snare system" to facilitate the catheter delivery system into the mitral annulus. Transoesophageal echocardiography and fluoroscopy were utilised for device positioning and deployment. The mitral valve prosthesis was implanted with mild mitral regurgitation. The postoperative course was uneventful and at 30-day follow-up the patient is in NYHA Class I, with good function of the mitral valve bioprosthesis. Conclusions: This procedure shows that percutaneous transfemoral transcatheter mitral valve implantation is feasible, safe and successful. Further experience is needed to render this procedure clinically available.

Ussia, G.P., Quadri, A., Cammalleri, V., De Vico, P., Muscoli, S., Marchei, M., et al. (2016). Percutaneous transfemoral-transseptal implantation of a second-generation CardiAQ™ mitral valve bioprosthesis: first procedure description and 30-day follow-up. EUROINTERVENTION, 11(10), 1126-1131 [10.4244/EIJY15M09_01].

Percutaneous transfemoral-transseptal implantation of a second-generation CardiAQ™ mitral valve bioprosthesis: first procedure description and 30-day follow-up

USSIA, GIAN PAOLO;CAMMALLERI, VALERIA;DE VICO, PASQUALE;MUSCOLI, SAVERIO;RUVOLO, GIOVANNI;ROMEO, FRANCESCO;
2016

Abstract

Aims: Transcatheter mitral valve implantation for mitral valve regurgitation is in the very early phase of development because of challenging anatomy and device dimensions. We describe the procedure of a transfemoral-transseptal implantation of the second-generation CardiAQ™ mitral valve bioprosthesis and 30-day follow-up. Methods and results: The procedure was performed percutaneously, without any left extracorporeal circulatory support. The patient had severe mitral regurgitation with severely depressed ventricular function and other comorbidities. The patient was deemed extreme high risk for conventional cardiac surgery by a multidisciplinary team. The main procedural steps were the creation of an arteriovenous loop with an exchange nitinol wire, and the use of a customised "steerable snare system" to facilitate the catheter delivery system into the mitral annulus. Transoesophageal echocardiography and fluoroscopy were utilised for device positioning and deployment. The mitral valve prosthesis was implanted with mild mitral regurgitation. The postoperative course was uneventful and at 30-day follow-up the patient is in NYHA Class I, with good function of the mitral valve bioprosthesis. Conclusions: This procedure shows that percutaneous transfemoral transcatheter mitral valve implantation is feasible, safe and successful. Further experience is needed to render this procedure clinically available.
Pubblicato
Rilevanza internazionale
Articolo
Comitato scientifico
Settore MED/23 - Chirurgia Cardiaca
Settore MED/11 - Malattie dell'Apparato Cardiovascolare
English
Con Impact Factor ISI
Bioprosthesis; Mitral valve regurgitation; Transcatheter valve replacement; Transfemoral access; Cardiology and Cardiovascular Medicine
Aged; Cardiac Catheterization; Follow-Up Studies; Humans; Male; Mitral Valve; Mitral Valve Insufficiency; Prosthesis Design; Prosthesis Failure; Treatment Outcome; Bioprosthesis; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Cardiology and Cardiovascular Medicine
http://www.pcronline.com/eurointervention/94th_issue/volume-11/number-10/228/percutaneous-transfemoral-transseptal-implantation-of-a-second-generation-cardiaq-mitral-valve-bioprosthesis-first-procedure-description-and-30-day-follow-up.html
Ussia, G.P., Quadri, A., Cammalleri, V., De Vico, P., Muscoli, S., Marchei, M., et al. (2016). Percutaneous transfemoral-transseptal implantation of a second-generation CardiAQ™ mitral valve bioprosthesis: first procedure description and 30-day follow-up. EUROINTERVENTION, 11(10), 1126-1131 [10.4244/EIJY15M09_01].
Ussia, Gp; Quadri, A; Cammalleri, V; DE VICO, P; Muscoli, S; Marchei, M; Ruvolo, G; Sondergaard, L; Romeo, F; Cammalleri, V
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/181722
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