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Author Notes:

Dr Vasilis Babaliaros, Emory University Hospital Midtown, 550 Peachtree Street, 4th Floor, Davis Fischer Building, Atlanta, Georgia 30308, USA. Email: vbabali@emory.edu

Dr Babaliaros has served as a consultant for Edwards Lifesciences and Abbott Vascular; has an employer with research contracts for clinical investigation of transcatheter aortic, mitral, and tricuspid devices from Edwards Lifesciences, Abbott Vascular, Medtronic, and Boston Scientific; and owns equity interest in Transmural Systems. Dr Lederman has served as the principal investigator on a cooperative research and development agreement between National Institutes of Health and Edwards Lifesciences for transcatheter modification of the mitral valve. Drs Lederman, Khan, and Rogers are co-inventors on patents, assigned to the National Institutes of Health, on devices for electrosurgical leaflet laceration. Drs Khan and Rogers have served as proctors for Edwards Lifesciences and Medtronic. Mr Kohli has served as a consultant for Abbott Laboratories. Dr Paone has served as a consultant and proctor for Edwards Lifesciences. Dr Lisko’s employer has contracts for BASILICA analysis with Medtronic and Edwards Lifesciences. Dr Greenbaum has served as a proctor for Edwards Lifesciences, Medtronic, and Abbott Vascular; owns an equity interest in Transmural Systems; and has an employer with research contracts for clinical investigation of transcatheter aortic, mitral, and tricuspid devices from Edwards Lifesciences, Abbott Vascular, Medtronic, and Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Subject:

Research Funding:

This work was supported by the Emory Structural Heart and Valve program intramural funds, and by National Institutes of Health Grant No. Z01-HL006040.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • mitral annular calcification
  • LAMPOON
  • SAPIEN 3
  • transcatheter electrosurgery
  • transcatheter mitral valve replacement
  • valve-in-ring
  • OUTFLOW TRACT OBSTRUCTION
  • LEAFLET
  • LACERATION
  • TMVR

The Art of SAPIEN 3 Transcatheter Mitral Valve Replacement in Valve-in-Ring and Valve-in-Mitral-Annular-Calcification Procedures

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Journal Title:

JACC-CARDIOVASCULAR INTERVENTIONS

Volume:

Volume 14, Number 20

Publisher:

, Pages E286-2214

Type of Work:

Article | Post-print: After Peer Review

Abstract:

The SAPIEN 3 is the only transcatheter heart valve commercially available for compassionate transcatheter mitral valve replacement in patients with previous mitral surgical rings and mitral annular calcification (valve in ring [VIR] and valve in mitral annular calcification [VIM]). Reported outcomes have been inconsistent or poor. The review provides an overview of the authors’ approach to achieve largely consistent results despite the intrinsic limitations of SAPIEN 3 VIM and VIR. The approach includes bedside modifications of the valve implant, the delivery system, and of the cardiac substrate itself. Until purpose-built devices are readily available, VIR and VIM procedures will require aggressive multidisciplinary cooperation, meticulous planning and execution, and postprocedure management by experienced, high-volume operators.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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