Journal article
Outcomes following transcatheter transseptal versus transapical mitral valve-in-valve and valve-in-ring procedures
Journal of cardiovascular and thoracic research, v 10(4), pp 182-186
01 Jan 2018
PMID: 30680074
Abstract
Introduction: Transcatheter mitral valve-in-valve (ViV) & valve-in-ring (ViR) are relatively novel
therapeutic alternatives for patients with degenerated bioprostheses or failed annuloplasty rings
whose reoperative risk is too high. The predominant procedural access for both procedures is
transapical or transseptal. However, whether there are differences in outcomes of this procedure
using transseptal versus transapical access has not yet been defined.
Methods: We conducted a systematic review of all published articles from MEDLINE and
EMBASE to explore the outcomes of these two procedural approaches.
Results:total of 55 studies including 183 patients (154 ViV and 29 ViR) were included. Patients
that underwent ViV (101 transapical and 53 transseptal) using the transseptal approach required
more iatrogenic atrial septal defect (ASD) closure (19% versus 0.0 %; P < 0.001) and hence had a
lower device success rate (68% versus 89%; P = 0.001). However, there was no significant difference
between the two groups in procedural success and all-cause mortality at 30 days. Overall severe
bleeding complications (major or life threatening) were not different the two groups (3.7% versus
7.9%; P = 0.321). In the ViR group (19 transapical and 10 transseptal), no difference in procedural
success, device success or 30-day outcomes were identified between transseptal and transapical
groups, although sample size was small.
Conclusion: In conclusion, mitral ViV and ViR using the two different procedural approaches appear to confer equal and reasonable 30-day outcomes.
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Details
- Title
- Outcomes following transcatheter transseptal versus transapical mitral valve-in-valve and valve-in-ring procedures
- Creators
- Salik Nazir (Corresponding Author) - Reading HospitalSaroj Lohani - Reading HospitalNiranjan Tachamo - Reading HospitalMuhammad Sohail Khan - Reading HospitalBidhya Timilsina - Reading HospitalFaraz Khan Luni - Mercy St. Vincent Medical CenterAnthony Donato - Thomas Jefferson University
- Publication Details
- Journal of cardiovascular and thoracic research, v 10(4), pp 182-186
- Publisher
- Tabriz University of Medical Sciences
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); General Internal Medicine
- Web of Science ID
- WOS:000456121100001
- Scopus ID
- 2-s2.0-85087443394
- Other Identifier
- 991022161731904721