Dr. Gian Paolo Ussia
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.
New techniques in mitral valve repair
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