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. 2013 Jul 25;4(3):e0015.
doi: 10.5041/RMMJ.10115. Print 2013 Jul.

Mitral transcatheter technologies

Francesco Maisano  1 , Nicola Buzzatti, Maurizio Taramasso, Ottavio Alfieri
Affiliations

Mitral transcatheter technologies

Francesco Maisano et al. Rambam Maimonides Med J. .

Abstract

Mitral valve regurgitation (MR) is often diagnosed in patients with heart failure and is associated with worsening of symptoms and reduced survival. While surgery remains the gold standard treatment in low-risk patients with degenerative MR, in high-risk patients and in those with functional MR, transcatheter procedures are emerging as an alternative therapeutic option. MitraClip(®) is the device with which the largest clinical experience has been gained to date, as it offers sustained clinical benefit in selected patients. Further to MitraClip implantation, several additional approaches are developing, to better match with the extreme variability of mitral valve disease. Not only repair is evolving, initial steps towards percutaneous mitral valve implantation have already been undertaken, and initial clinical experience has just started.

Keywords: Mitral regurgitation; mitral valve; percutaneous; valve repair; valve replacement.

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Figures

Figure 1
Figure 1
MitraClip® System. A and B: The delivery system in use from lateral and above views, in a live case. C: Fluoroscopic view. D: Echo-view during grasping.
Figure 2
Figure 2
The V-Chordal Device, a Surgically Implantable Adjustable Chordae Device. The device can be implanted with a sutureless approach, which opens the perspective of fully percutaneous implants. The length of the chordae can be adjusted on the beating heart for optimal coaptation. A: A drawing depicting the concept. B: An animal model post-mortem examination showing the adjusting device in the tip of the papillary muscle with chordae attached on the free edge of the anterior leaflet.
Figure 3
Figure 3
Coronary Sinus Annuloplasty: the CARILLON Concept. The Carillon device is composed of a nitinol bar with two anchors. The device is implanted in the coronary sinus to foreshorten the adjacent mitral annulus.
Figure 4
Figure 4
The Direct Annuloplasty Cardioband System in a Patient Immediately after Implantation. The device closely reproduces a surgical annuloplasty band, but is implanted percutaneously, with a transseptal approach.
Figure 5
Figure 5
Perivalvular Leak Closure with the Amplatzer AVPIII Device. This 3D image shows a vascular plug implanted in a lateral leak of the mitral valve. The role of echo imaging is of paramount importance in this field.
Figure 6
Figure 6
The Cardiovalve (Valtech-cardio). A: The Cardiovalve in situ in an animal model, with no perivalvular regurgitation and optimal competence of the valve. B: A 3D view of deployment. C: A 3D view from the atrial perspective of the implanted Cardiovalve.
Figure 7
Figure 7
Valve-in-ring Procedure. Fluoroscopic image of Edwards SAPIEN XT 26 deployment into a previously implanted C-E Physio ring 28.
See this image and copyright information in PMC

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