Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses

Moritz Seiffert; Lenard Conradi; Stephan Baldus; Johannes Schirmer; Malgorzata Knap; Stefan Blankenberg; Hermann Reichenspurner; Hendrik Treede

doi:10.1016/j.jcin.2011.12.008

Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses

Standard

Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses. / Seiffert, Moritz; Conradi, Lenard; Baldus, Stephan; Schirmer, Johannes; Knap, Malgorzata; Blankenberg, Stefan ; Reichenspurner, Hermann ; Treede, Hendrik.

In: JACC-CARDIOVASC INTE, Vol. 5, No. 3, 03.2012, p. 341-349.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Seiffert, M, Conradi, L, Baldus, S, Schirmer, J, Knap, M, Blankenberg, S , Reichenspurner, H & Treede, H 2012, 'Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses', JACC-CARDIOVASC INTE, vol. 5, no. 3, pp. 341-349. https://doi.org/10.1016/j.jcin.2011.12.008

APA

Seiffert, M., Conradi, L., Baldus, S., Schirmer, J., Knap, M., Blankenberg, S., Reichenspurner, H., & Treede, H. (2012). Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses. JACC-CARDIOVASC INTE, 5(3), 341-349. https://doi.org/10.1016/j.jcin.2011.12.008

Vancouver

Seiffert M, Conradi L, Baldus S, Schirmer J, Knap M, Blankenberg S et al. Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses. JACC-CARDIOVASC INTE. 2012 Mar;5(3):341-349. https://doi.org/10.1016/j.jcin.2011.12.008

Bibtex

@article{2a137ba9dc9741cda1ce4100d8e63af3,

title = "Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses",

abstract = "OBJECTIVES: This study reports the results of a series of transapical mitral valve-in-valve implantations and aims to offer guidance on technical aspects of the procedure.BACKGROUND: Mitral valve reoperations due to failing bioprostheses are associated with high morbidity and mortality. Transcatheter techniques may evolve as complementary approaches to surgery in these high-risk patients.METHODS: Six patients (age 75 ± 15 years) received transapical implantation of a balloon-expandable pericardial heart valve into a degenerated bioprosthesis (range 27 to 31 mm) in mitral position at our institution. All patients were considered high risk for surgical valve replacement (logistic EuroSCORE: 33 ± 15%) after evaluation by an interdisciplinary heart team. Procedural and clinical outcomes were analyzed.RESULTS: Implantation was successful in all patients with reduction of mean transvalvular gradients from 11.3 ± 5.2 mm Hg to 5.5 ± 3.6 mm Hg (p = 0.016) and median regurgitation from grade 3.0 (interquartile range [IQR]: 2.7 to 3.1) to 0 (IQR: 0 to 1.0, p = 0.033) with trace paravalvular regurgitation remaining in 2 patients. Apical bleeding occurred in 2 patients requiring rethoracotomy in 1 and resuscitation in a second patient, the latter of whom died on postoperative day 6. In the remaining patients, median New York Heart Association functional class improved from 3.0 (IQR: 3.0 to 3.5) to 2.0 (IQR: 1.5 to 2.0, p = 0.048) over a median follow-up of 70 (IQR: 25.5 to 358) days.CONCLUSIONS: With acceptable results in a high-risk population, transapical mitral valve-in-valve implantation can be considered as a complementary approach to reoperative mitral valve surgery in select patients.",

keywords = "Aged, Aged, 80 and over, Bioprosthesis, Cardiac Catheterization/adverse effects, Catheterization, Female, Germany, Heart Valve Diseases/surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation/adverse effects, Humans, Logistic Models, Middle Aged, Mitral Valve/diagnostic imaging, Prosthesis Design, Prosthesis Failure, Radiography, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Ultrasonography",

author = "Moritz Seiffert and Lenard Conradi and Stephan Baldus and Johannes Schirmer and Malgorzata Knap and Stefan Blankenberg and Hermann Reichenspurner and Hendrik Treede",

year = "2012",

month = mar,

doi = "10.1016/j.jcin.2011.12.008",

language = "English",

volume = "5",

pages = "341--349",

journal = "JACC-CARDIOVASC INTE",

issn = "1936-8798",

publisher = "Elsevier Inc.",

number = "3",

}

RIS

TY - JOUR

T1 - Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses

AU - Seiffert, Moritz

AU - Conradi, Lenard

AU - Baldus, Stephan

AU - Schirmer, Johannes

AU - Knap, Malgorzata

AU - Blankenberg, Stefan

AU - Reichenspurner, Hermann

AU - Treede, Hendrik

PY - 2012/3

Y1 - 2012/3

N2 - OBJECTIVES: This study reports the results of a series of transapical mitral valve-in-valve implantations and aims to offer guidance on technical aspects of the procedure.BACKGROUND: Mitral valve reoperations due to failing bioprostheses are associated with high morbidity and mortality. Transcatheter techniques may evolve as complementary approaches to surgery in these high-risk patients.METHODS: Six patients (age 75 ± 15 years) received transapical implantation of a balloon-expandable pericardial heart valve into a degenerated bioprosthesis (range 27 to 31 mm) in mitral position at our institution. All patients were considered high risk for surgical valve replacement (logistic EuroSCORE: 33 ± 15%) after evaluation by an interdisciplinary heart team. Procedural and clinical outcomes were analyzed.RESULTS: Implantation was successful in all patients with reduction of mean transvalvular gradients from 11.3 ± 5.2 mm Hg to 5.5 ± 3.6 mm Hg (p = 0.016) and median regurgitation from grade 3.0 (interquartile range [IQR]: 2.7 to 3.1) to 0 (IQR: 0 to 1.0, p = 0.033) with trace paravalvular regurgitation remaining in 2 patients. Apical bleeding occurred in 2 patients requiring rethoracotomy in 1 and resuscitation in a second patient, the latter of whom died on postoperative day 6. In the remaining patients, median New York Heart Association functional class improved from 3.0 (IQR: 3.0 to 3.5) to 2.0 (IQR: 1.5 to 2.0, p = 0.048) over a median follow-up of 70 (IQR: 25.5 to 358) days.CONCLUSIONS: With acceptable results in a high-risk population, transapical mitral valve-in-valve implantation can be considered as a complementary approach to reoperative mitral valve surgery in select patients.

AB - OBJECTIVES: This study reports the results of a series of transapical mitral valve-in-valve implantations and aims to offer guidance on technical aspects of the procedure.BACKGROUND: Mitral valve reoperations due to failing bioprostheses are associated with high morbidity and mortality. Transcatheter techniques may evolve as complementary approaches to surgery in these high-risk patients.METHODS: Six patients (age 75 ± 15 years) received transapical implantation of a balloon-expandable pericardial heart valve into a degenerated bioprosthesis (range 27 to 31 mm) in mitral position at our institution. All patients were considered high risk for surgical valve replacement (logistic EuroSCORE: 33 ± 15%) after evaluation by an interdisciplinary heart team. Procedural and clinical outcomes were analyzed.RESULTS: Implantation was successful in all patients with reduction of mean transvalvular gradients from 11.3 ± 5.2 mm Hg to 5.5 ± 3.6 mm Hg (p = 0.016) and median regurgitation from grade 3.0 (interquartile range [IQR]: 2.7 to 3.1) to 0 (IQR: 0 to 1.0, p = 0.033) with trace paravalvular regurgitation remaining in 2 patients. Apical bleeding occurred in 2 patients requiring rethoracotomy in 1 and resuscitation in a second patient, the latter of whom died on postoperative day 6. In the remaining patients, median New York Heart Association functional class improved from 3.0 (IQR: 3.0 to 3.5) to 2.0 (IQR: 1.5 to 2.0, p = 0.048) over a median follow-up of 70 (IQR: 25.5 to 358) days.CONCLUSIONS: With acceptable results in a high-risk population, transapical mitral valve-in-valve implantation can be considered as a complementary approach to reoperative mitral valve surgery in select patients.

KW - Aged

KW - Aged, 80 and over

KW - Bioprosthesis

KW - Cardiac Catheterization/adverse effects

KW - Catheterization

KW - Female

KW - Germany

KW - Heart Valve Diseases/surgery

KW - Heart Valve Prosthesis

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Humans

KW - Logistic Models

KW - Middle Aged

KW - Mitral Valve/diagnostic imaging

KW - Prosthesis Design

KW - Prosthesis Failure

KW - Radiography

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Time Factors

KW - Treatment Outcome

KW - Ultrasonography

U2 - 10.1016/j.jcin.2011.12.008

DO - 10.1016/j.jcin.2011.12.008

M3 - SCORING: Journal article

C2 - 22440502

VL - 5

SP - 341

EP - 349

JO - JACC-CARDIOVASC INTE

JF - JACC-CARDIOVASC INTE

SN - 1936-8798

IS - 3

ER -