Guest Editor(s)

• Prof. Manel Sabaté, MD, PhD

  Interventional Cardiology Unit, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.

  Website | E-mail

Special Issue Introduction

Transcatheter treatment of valve disease has evolved rapidly in the last years. Aortic stenosis has been the first valve disease in which a percutaneous approach can be considered as the first choice in certain clinical conditions (high-risk patients) or as an alternative to classical cardiac surgery in others (intermediate and low-risk patients). Treatment of mitral valve disease has also been the matter of research although specific anatomical features of the mitral valve apparatus have made technical advancements in this setting more complex. After more than one decade of experience, edge-to-edge repair has emerged as the first percutaneous treatment of mitral regurgitation with clinical efficacy. In turn, percutaneous mitral replacement may represent a major breakthrough in the field but it is still in its infancy with a bunch of prototypes being tested in first-in-human studies but none in large randomized controlled trials. In this special issue, we will review the current status of the percutaneous repair technology with the advent of new competitors in the field. In addition, future trends in mitral valve replacement will be addressed to elucidate the potential and drawbacks of this technique.

Keywords

Mitral valve, mitral regurgitation, percutaneous edge-to-edge mitral repair, percutaneous mitral valve replacement, clinical trials

Submission Deadline

30 Nov 2020

Submission Information

For Author Instructions, please refer to http://vpjournal.net/pages/view/author_instructions
For Online Submission, please login at https://oaemesas.com/login?JournalId=vp&SpecialIssueId=483
Submission Deadline: 30 Nov 2020
Contacts: Grace Zheng, Assistant Editor, grace@vpjournal.net

Planned Papers

Type: Case Report

Title: Mitral p2 perforation during mitraclip grasping manoeuver, intraprocedural detectation

Authors: Maria-Cruz Ferrer-Gracia

Affiliations: Hemodynamic and Interventional Cardiology Unit, Cardiology Institution, Miguel Servet University Hospital, Zaragoza, Spain.

Abstract: We present a leaflet perforation in an old woman after the first attempt of grasping manoeuvre. During final echocardiographic verifications, just before the releasing of the clip, her mitral regurgitation was worsened. Therefore, we decided to invert the clip and return to the left atrium. After an exhaustive scanning, we observed a new jet inside one leaflet (P2) of the mitral valve. For fear that a new grasping would cause a new jet, a surgical approach was decided to be performed.Intraoperatory images confirmed the tear in the middle of P2. A mechanical mitral prosthesis was successfully implanted and the patient nicely recovered. Mitral leaflet disruption is a rare but serious complication of Mitraclip insertion. In previous reported cases, this condition was observed just in patients who required a surgical approach after clip implantation. Never before has it been described during grasping manoeuvres without liberation of the clip.

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Type: Review

Title: Patient selection for transcatheter mitral valve repair vs. replacement: ongoing indications and a glimpse into the future

Authors: Andrea Scotti¹, Cosmo Godino²

Affiliations: ¹Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy.
²Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.

Corresponding Author: Cosmo Godino, MD, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute Via Olgettina 60, 20132 Milan, Italy. E-mail: godino.cosmo@hsr.it

Abstract: Transcatheter therapies for patients with severe mitral regurgitation have been increasingly performed in recent years. While transcatheter mitral valve repair (TMVR) is now a consolidated intervention with > 100,000 procedures performed worldwide, TMV replacement (TMVRpl) is in its early stages and can only be performed by few centers. The complexity of mitral valve anatomy requires careful evaluation in selecting the best approach and the most suitable device. At present, the clinical experience with TMVRpl is still in a preliminary phase. Most of the patients treated with this approach currently are really high-risk candidates who have undergone a very restrictive clinical and anatomical selection. Therefore, it is difficult to accurately define which patients might benefit more from TMVRpl than from TMVR. Hereafter, we review the clinical, pathophysiological and technical factors to suggest when to prefer TMVR to a replacement technique.

Keywords: Mitral regurgitation, mitral valve repair, mitral valve replacement

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