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Acute ST-elevation myocardial infarction (STEMI) is a life-threatening condition often associated with significant cardiac complications, particularly in the presence of underlying multivessel coronary artery disease. Mechanical complications, such as acute mitral regurgitation (MR), can worsen the clinical course, leading to rapid hemodynamic deterioration. Recent advancements in mechanical circulatory support and percutaneous interventions have introduced new therapeutic options, offering viable alternatives to traditional surgery for high-risk patients.
View Article and Find Full Text PDFSelecting the optimal candidates for percutaneous mitral valvuloplasty using multi-modality imaging.
Eur Heart J Cardiovasc Imaging
December 2024
Division of Radiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Aims: This study compared echocardiography (echo) and cardiac computed tomography (CT) in measuring the Wilkins score and evaluated the potential added benefit of CT in predicting immediate percutaneous mitral valvuloplasty (PMV) outcomes in rheumatic mitral stenosis (MS) patients deemed eligible for PMV by echo.
Methods And Results: From a multicentre registry of 3,140 patients with at least moderate MS, we included 96 patients (age 56.4±11.
Acute Decompensated Valvular Disease in the Intensive Care Unit.
JACC Adv
December 2024
TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Acute decompensated valvular disease encompasses a group of complex and challenging conditions, which are often the primary reason for admission to the cardiac intensive care unit and can also complicate the management of other primary cardiac disorders. Critically ill patients with valvular disease also present unique diagnostic and management challenges. Historically, medical and percutaneous interventional therapies have been limited and surgery was the only definitive treatment; however, surgical risk can at times be prohibitive.
View Article and Find Full Text PDFA Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device.
Cardiovasc Eng Technol
December 2024
Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Purpose: Advancements in minimally invasive technologies to decrease postoperative morbidity and recovery times represent a large opportunity for mitral valve repair operations. However, current technologies are unable to replicate gold standard surgical neochord implantation.
Methods: We developed a novel neochordal repair device, Minimally Invasive Ventricular Anchoring Neochordoplasty (MIVAN), which operates via transcatheter, trans-septal anchoring to the posterior ventricular wall.
Days at Home After Transcatheter Mitral Valve Repair Versus Medical Therapy Alone in Heart Failure.
J Am Heart Assoc
December 2024
Smith Center for Outcomes Research in Cardiology, Division of Cardiovascular Medicine, Department of Medicine Beth Israel Deaconess Medical Center Boston MA USA.
Background: Transcatheter edge-to-edge repair of the mitral valve (mTEER) reduced a hierarchical end point that included death and heart failure hospitalization in COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation Trial). However, the magnitude to which mTEER increases the number of days a patient spends at home (DAH) in the first few years after treatment, a patient-centered end point not captured routinely in clinical trials, has not been evaluated. We compared 1- and 2-year DAH among patients with functional mitral regurgitation and heart failure randomized to mTEER plus medical therapy versus medical therapy alone (control) by linking the COAPT trial to comprehensive health care claims data.
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