Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes

Fatma Aboalsoud Taha, MD; Hesham Naeim, MD; Osama Amoudi, MD; Fareed Alnozha, MD; Mansour Almutairi, MD; Reda Abuelatta, MD

Structural Heart (Jul 2022)

Transcatheter Mitral Valve Repair Technique in Specific Severe Mitral Regurgitation: Tips, Tricks, and Outcomes

Fatma Aboalsoud Taha, MD,
Hesham Naeim, MD,
Osama Amoudi, MD,
Fareed Alnozha, MD,
Mansour Almutairi, MD,
Reda Abuelatta, MD

Affiliations

Fatma Aboalsoud Taha, MD: Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia; Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Address correspondence to: Fatma Aboalsoud Taha, MD, Assistant Professor and Consultant of Cardiology and Congenital Heart Disease, Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt; Consultant of Cardiology and Adult Congenital Heart Disease, Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia
Hesham Naeim, MD: Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia
Osama Amoudi, MD: Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia
Fareed Alnozha, MD: Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia
Mansour Almutairi, MD: Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia
Reda Abuelatta, MD: Adult Cardiology Department, Madinah Cardiac Center, Madinah, Saudi Arabia

Journal volume & issue: Vol. 6, no. 3
p. 100043

Abstract

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Background: In specific patients with severe mitral regurgitation (MR), mitral valve (MV) pathology is unique and requires creative transcatheter repair techniques. This study aimed to evaluate the feasibility and safety of a new transcatheter MV repair technique, using occluder devices in symptomatic high-surgical-risk patients with severe MR, either due to MV leaflet (MVL) perforations or due to post-clips residual MR, and to report on their 6-month outcomes. Methods: The study enrolled all high-risk patients with severe MR due to MVL perforations and post-clips residual MR who underwent transcatheter MV repair using occluder devices, from November 2016 to August 2019. Results: The study enrolled 16 patients; 9 (56.25%) with MVL perforations and 7 (43.75%) with post-MitraClip (Abbott Laboratories, Abbott Park, Illinois) residual MR, with a mean age of 55.75 ± 16.69 years. Mean perforation/jet diameters were 5.75 ± 1.67 and 6.5 ± 1.93 mm, and the mean 3D-vena contracta area was 0.54 ± 0.14 cm2. Perforations were crossed retrograde (transaortic in 7 [43.75%] patients and transapical in 2 [12.5%] patients), and post-MitraClip devices residual jets were crossed antegrade (transvenous/transseptal). Six (37.5%) patients required arteriovenous loop formation for device deployment, that was antegrade transvenous/transseptal in 13 (81.25%) patients and retrograde transapical in 3 (18.75%) patients. Devices used were Amplatzer-ASO in 10 (62.5%) patients and Amplatzer-VP-II in 6 (37.5%) patients. Mean procedural and fluoroscopy times were 55.13 ± 16.24 and 16.25 ± 4.03 minutes, respectively. Patients passed successfully, without MV gradient change or device-related complications. Conclusions: Transcatheter MV repair of MVL perforations/post-clips residual MR is a new, feasible, and safe technique for high-surgical-risk patients.

Published in Structural Heart

ISSN: 2474-8706 (Print); 2474-8714 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/structural-heart

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