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New techniques in mitral valve repair

Session presentations
  • Transapical neochord insertion. Presented by J Seeburger (Leipzig, DE) See the slides
  • Percutaneous mitral annuloplasty. Presented by F Maisano (Segrate, IT) See the slides
  • Percutaneous edge-to-edge repair. Presented by OW Franzen (Copenhagen, DK) See the slides
  • Transcatheter mitral valve replacement. Presented by G Lutter (Kiel, DE) See the slides


New transcatheter therapeutic options are emerging on the horizon for the treatment of mitral valve regurgitation. This was the take home message from the session  “new techniques in mitral valve repair” held on the 27th of august in room Cairo. The panel included  three cardiac surgeons and one interventional cardiologist. The speakers provided   updates about  clinically available and experimental transcatheter  devices for  the treatment of degenerative and functional mitral regurgitation.

Joerg  Seeburger (Leipzig)  spoke about a device that delivers artifical chordae tendinae in a beating heart using transapical  access under  echocardiographic guidance and the related  preliminay data of the multicenter clinical TransApical Chordae Tendinae.  Francesco Maisano (Milan) described the transcatheter annuloplasty techniques: the experimental direct annuloplasty, septolateral cinching and external compression, and the clinically available device for  coronary sinus remodeling, which showed a good performance in the pilot study TITAN trial.

Olaf Franzen (Copenaghen) updated on the real world experience of percutaneous edge to edge repair, with clips which had reached > then 5000  implants with good  results in terms of  safety and quality of life improvement. He outlined how Mitraclip is a promising tool for treating  patients at high risk for surgical repair. George Lutter (Kiel) spoke about  the very  new transcatheter mitral valve prosthesis, which is implanted in mitral position with transapical or transfemoral access. While still in the experimental phase, this therapy could extend the indications of mitral valve pathologies  suitable for a transcatheter approach.

This session reiterated the important synergy of ideas and techniques between cardiac surgery and interventional cardiology. The  mitral valve anatomy is complex and it will need some years for clinical application of all the devices, however the research and technical implentation of these technologies is progressing rapidly such that  in the future, the treating physician will have a range of available  options to select from and apply to the specific mitral valve pathology in a particular patient improving safety and outcomes.

References


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New techniques in mitral valve repair

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.