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Emerging approaches of transcatheter valve repair/insertion.

Taramasso M, Cioni M, Giacomini A, Michev I, Godino C, Montorfano M, Colombo A, Alfieri O, Maisano F - Cardiol Res Pract (2010)

Bottom Line: Aortic stenosis (AS) and mitral regurgitation (MR) account for the majority of valvular diseases and their prevalence is increasing according to increased life expectancy.A large part of the patients at high surgical risk who could beneficiate of treatment are not referred to surgery.Therefore, there is a need of alternative and less invasive procedures.

View Article: PubMed Central - PubMed

Affiliation: Cardiothoracic Department, San Raffaele Scientific Institute, via Olgettina 60, 20122 Milan, Italy.

ABSTRACT
Aortic stenosis (AS) and mitral regurgitation (MR) account for the majority of valvular diseases and their prevalence is increasing according to increased life expectancy. Surgical treatment is the gold standard, although operative risk may be high in some patients due to comorbidities and age. A large part of the patients at high surgical risk who could beneficiate of treatment are not referred to surgery. Therefore, there is a need of alternative and less invasive procedures.

No MeSH data available.


Related in: MedlinePlus

The Mitraclip device is a two-armed, polyester-covered, fixation device. Each arm has an opposing gripper that aids the leaflets in the clip by means of multipronged friction element.
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fig3: The Mitraclip device is a two-armed, polyester-covered, fixation device. Each arm has an opposing gripper that aids the leaflets in the clip by means of multipronged friction element.

Mentions: The most advanced percutaneous MV repair procedure is the Alfieri edge-to-edge repair using the Evalve Percutaneous Mitral Repair System, also known as MitraClip device (Evalve, Inc., CA, USA—Figure 3). The Alfieri repair consists in suturing the free edge of the anterior mitral leaflet to the free edge of the posterior leaflet at the site of the regurgitation. The result is a double-orifice valve with improved leaflet coaptation. This surgical procedure has proven early efficacy and durability in various anatomic and functional lesions [56–58]. The Mitraclip system reproduces the surgical procedure using a clip to join the free edges of the opposing leaflets [59]. This procedure involves transseptal cannulation of the left atrium and positioning the delivery system perpendicular to the MV. Under TEE guidance, the clip is placed to appose the two mitral leaflets, creating a double-orifice valve. The reduction of the MR severity is real-time assessed and, if necessary, it may be repositioned to reduce MR further. The operator should be familiar with echo imaging and a close collaboration between the operator and the echocardiographist is mandatory to run the procedure safely and efficiently. Live 3D echocardiography is very helpful particularly for clip orientation and alignment on the coaptation line. Final echo assessment should be done under vasoconstrictors. When the result is satisfactory, the clip is deployed and the delivery system is removed. In case of persistent significant MR (>2+/4+), a second clip may be placed.


Emerging approaches of transcatheter valve repair/insertion.

Taramasso M, Cioni M, Giacomini A, Michev I, Godino C, Montorfano M, Colombo A, Alfieri O, Maisano F - Cardiol Res Pract (2010)

The Mitraclip device is a two-armed, polyester-covered, fixation device. Each arm has an opposing gripper that aids the leaflets in the clip by means of multipronged friction element.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2926577&req=5

fig3: The Mitraclip device is a two-armed, polyester-covered, fixation device. Each arm has an opposing gripper that aids the leaflets in the clip by means of multipronged friction element.
Mentions: The most advanced percutaneous MV repair procedure is the Alfieri edge-to-edge repair using the Evalve Percutaneous Mitral Repair System, also known as MitraClip device (Evalve, Inc., CA, USA—Figure 3). The Alfieri repair consists in suturing the free edge of the anterior mitral leaflet to the free edge of the posterior leaflet at the site of the regurgitation. The result is a double-orifice valve with improved leaflet coaptation. This surgical procedure has proven early efficacy and durability in various anatomic and functional lesions [56–58]. The Mitraclip system reproduces the surgical procedure using a clip to join the free edges of the opposing leaflets [59]. This procedure involves transseptal cannulation of the left atrium and positioning the delivery system perpendicular to the MV. Under TEE guidance, the clip is placed to appose the two mitral leaflets, creating a double-orifice valve. The reduction of the MR severity is real-time assessed and, if necessary, it may be repositioned to reduce MR further. The operator should be familiar with echo imaging and a close collaboration between the operator and the echocardiographist is mandatory to run the procedure safely and efficiently. Live 3D echocardiography is very helpful particularly for clip orientation and alignment on the coaptation line. Final echo assessment should be done under vasoconstrictors. When the result is satisfactory, the clip is deployed and the delivery system is removed. In case of persistent significant MR (>2+/4+), a second clip may be placed.

Bottom Line: Aortic stenosis (AS) and mitral regurgitation (MR) account for the majority of valvular diseases and their prevalence is increasing according to increased life expectancy.A large part of the patients at high surgical risk who could beneficiate of treatment are not referred to surgery.Therefore, there is a need of alternative and less invasive procedures.

View Article: PubMed Central - PubMed

Affiliation: Cardiothoracic Department, San Raffaele Scientific Institute, via Olgettina 60, 20122 Milan, Italy.

ABSTRACT
Aortic stenosis (AS) and mitral regurgitation (MR) account for the majority of valvular diseases and their prevalence is increasing according to increased life expectancy. Surgical treatment is the gold standard, although operative risk may be high in some patients due to comorbidities and age. A large part of the patients at high surgical risk who could beneficiate of treatment are not referred to surgery. Therefore, there is a need of alternative and less invasive procedures.

No MeSH data available.


Related in: MedlinePlus