Transcatheter Mitral Valve Implantation Using the HighLife System

Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved..

OBJECTIVES: This study is the first report of 2 cases of HighLife (HighLife, Paris, France) implantation in humans.

BACKGROUND: Transcatheter mitral valve implantation represents a promising approach to treating mitral regurgitation in patients at increased risk of perioperative mortality. The HighLife transcatheter mitral valve is a 2-component system. The valve is implanted in the mitral position and is anchored by interacting and then reaching an equilibrium position with a previously positioned subannular implant.

METHODS: The procedures were successfully performed in a 69-year-old man and a 65-year-old woman with severe functional mitral regurgitation. Both patients were in New York Heart Association functional class IV heart failure with depressed left ventricular ejection fraction and additional comorbidities.

RESULTS: The valve was implanted uneventfully in both patients. General anesthesia was used. The subannular implant was deployed through the transfemoral access, whereas the transcatheter mitral valve was released using the transapical access. Patients maintained hemodynamically stable. There were no intraoperative complications. Acutely, post-procedural echocardiograms demonstrated excellent prosthetic valve function with a low transvalvular gradient and no paravalvular leak and left ventricular outflow tract obstruction. Both patients had mild intraprosthetic regurgitation. Patient #1 survived at 5-months follow-up in New York Heart Association functional class II with excellent prosthesis performance. Patient #2 expired 4 days after a technically successful procedure, because the left ventricle did not tolerate the reduction of mitral regurgitation and despite a high dose of inotropic agents the left ventricular function rapidly deteriorated.

CONCLUSIONS: Transcatheter mitral valve implantation using the 2-component HighLife system is technically feasible and can be performed safely. Early hemodynamic performance of the prosthesis was excellent.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:10

Enthalten in:

JACC. Cardiovascular interventions - 10(2017), 16 vom: 28. Aug., Seite 1662-1670

Sprache:

Englisch

Beteiligte Personen:

Barbanti, Marco [VerfasserIn]
Piazza, Nicolò [VerfasserIn]
Mangiafico, Sarah [VerfasserIn]
Buithieu, Jean [VerfasserIn]
Bleiziffer, Sabine [VerfasserIn]
Ronsivalle, Giuseppe [VerfasserIn]
Scandura, Salvatore [VerfasserIn]
Giuffrida, Angelo [VerfasserIn]
Popolo Rubbio, Antonio [VerfasserIn]
Mazzamuto, Massimo [VerfasserIn]
Sgroi, Carmelo [VerfasserIn]
Lange, Rüdiger [VerfasserIn]
Tamburino, Corrado [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Journal Article
Mitral regurgitation
Prosthesis
Transcatheter mitral valve replacement
Video-Audio Media

Anmerkungen:

Date Completed 21.05.2018

Date Revised 25.01.2019

published: Print

Citation Status MEDLINE

doi:

10.1016/j.jcin.2017.06.046

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM275112942