Article

Transcatheter mitral valve replacement: A frontier in cardiac intervention

Amar Krishnaswamy, MD, Stephanie Mick, MD, Jose Navia, MD, A. Marc Gillinov, MD, E. Murat Tuzcu, MD and Samir R. Kapadia, MD
Cleveland Clinic Journal of Medicine November 2016, 83 (11 suppl 2) S10-S17; DOI: https://doi.org/10.3949/ccjm.83.s2.02

Article Figures & Data

Figures

  • FIGURE 1
    FIGURE 1

    Routes of transcatheter mitral valve replacement: (A) transseptal antegrade via the femoral vein; (B) transapical retrograde via direct left ventricular access.

    Reprinted with permission from Wolters Kluwer Health, Inc. (Sud K, et al. Degenerated mitral stenosis: unmet need for percutaneous interventions. Circulation 2016; 133:1594–1604).

  • Figure2

    Fortis valve

    Courtesy of Edwards Lifesciences.

  • Figure3

    Tendyne valve

    Reprinted from EuroIntervention (Perpetua EM, et al. The Tendyne transcatheter mitral valve implantation system. EuroIntervention 2015; 11:W78-W79.) © 2015 with permission from Europa Digital & Publishing.

  • Figure4

    NaviGate valve

    Courtesy of Jose Navia.

  • FIGURE 2
    FIGURE 2

    Transatrial implantation of the NaviGate transcatheter mitral valve replacement prosthesis. (A) Initial unsheathing of the valve (arrow) via the left atrium (LA); (B) no residual mitral regurgitation on left ventriculography (LV). Ao = ascending aorta

  • Figure6

    Intrepid valve

    Courtesy of Medtronic.

  • Figure7

    CardiAQ valve

    Courtesy of Edwards Lifesciences.

  • Figure8

    Tiara valve

    Reprinted from EuroInter-vention (Cheung A, et al. Transcatheter mitral valve implantation with Tiara bioprosthesis. EuroIntervention 2014; 10:U115-U119.) © 2014 with permission from Europa Digital & Publishing.

  • FIGURE 3
    FIGURE 3

    Mitral annular calcification (MAC) provides a “frame” for transcatheter mitral valve replacement prosthesis implantation in the mitral position for degenerative mitral stenosis. Ao = aorta; LVOT = left ventricular outflow tract

    Reprinted with permission from Wolters Kluwer Health, Inc. (Sud K, et al. Degenerated mitral stenosis: unmet need for percutaneous interventions. Circulation 2016; 133:1594–1604).

  • FIGURE 4
    FIGURE 4

    Transfemoral mitral valve-in-valve placement of a balloon-expandable valve. (A) Catheter via femoral vein (white arrow) and crossing the interatrial septum with unexpanded valve in place (black arrow) within the mitral prosthesis (arrowhead); (B) balloon inflation of the TAVR prosthesis (black arrow); (C) fully expanded valve in place; (D) 3D transesophageal echocardiographic view from the left atrium of the stenosed mitral valve (arrow); (E) mitral valve open (arrow) after valve-in-valve placement.

Tables

  • TABLE 1

    Percutaneous mitral valve repair devices

    Type of repairDeviceTechniqueStatus
    Edge-to-edge repairMitraClipV-shaped clip applied via femoral veinFDA approval for patients with degenerative mitral regurgitation
    COAPT trial for patients with functional mitral regurgitation
    CE Mark approval for all mitral regurgitation
    Indirect annuloplastyCarillonNitinol wire placed in the coronary sinus via the internal jugular veinUS trial being planned
    CE Mark approval
    Direct annuloplastyMitralignAnchors placed in the posterior annulus via femoral arteryFeasbility trial published
    Valtech CardiobandAnchors placed in the posterior annulus via the femoral veinFeasibility trial published
    Chordal repairNeoChordTransapical approachCE Mark approval
    Valve spacerMitra-SpacerBalloon placed in the mitral valve to reduce regurgitant orifice and improve coaptation, transfemoral and transapical deliveryFirst-in-man completed9
    Technology licensed for possible tricuspid valve use
    Chamber remodelingBasal annuloplasty of the cardia externally (BACE)Silicone band placed externally at the atrioventricular groove and inflatedFirst-in-man completed10

    • FDA = US Food and Drug Administration

Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools

Jump to section

Subjects