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Transcatheter Mitral Valve Implantation Systematic Review: Focus on Transseptal Approach and Mitral Annulus Calcification

  • Structural Heart Disease (RJ Siegel and NC Wunderlich, Section Editors)
  • Published:
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A Correction to this article was published on 03 April 2021

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Abstract

Introduction

This systematic review was performed to evaluate the results of transcatheter mitral valve implantation (TMVI) in the native mitral valve.

Evidence acquisition

Medline, EMBASE, and the Cochrane Central register were systematically searched for studies that reported results of TMVI in mitral valve regurgitation and/or stenosis and mitral annular calcification. To improve the sensitivity of the literature search, we performed citation chasing in Google Scholar, Scopus, and Web of Science.

Evidence synthesis

Twelve studies reporting results of TMVI in mitral regurgitation were retrieved and included 347 patients. The transseptal approach represented 28% of cases. Secondary mitral regurgitation was the predominant indication in 63% of cases. Thirty-day mortality was 11% and was lowered with the transseptal approach (7%). Technical success was 92%. Surgical conversion was needed in 5% of patients. Only one patient presented moderate to severe mitral regurgitation. These hemodynamic results were sustainable up to one year of follow-up. Three series focused on results of TMVI in mitral annulus calcification including 167 patients. Only nine patients were treated with TMVI dedicated prosthesis. Eighty-seven patients had their prosthesis delivered through a transseptal approach. Mitral stenosis was present in 63% of cases. Thirty-day mortality was 24%, and none with TMVI prosthesis. Technical success was achieved in 71% of cases and was improved by using TMVI prosthesis (89%). The main complication was left ventricular outflow tract obstruction (20%). Post procedural moderate to severe mitral regurgitation was observed in 4% of cases.

Conclusion

TMVI seems to be feasible, achieving good technical success and predictable and durable MR reduction.

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Funding

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Authors and Affiliations

  1. Service Médico-Chirurgical: Valvulopathies- Chirurgie Cardiaque – Cardiologie Interventionelle Structurelle, Hôpital Cardiologique de Haut Lévèque, CHU-Bordeaux, Bordeaux, France

    W. Ben-Ali & T. Modine

  2. Structural Valve Program, Montreal Heart Institute, Montréal, Canada

    W. Ben-Ali & R. Ibrahim

  3. Service de Chirurgie, Cardio-vasculaire Hôpital haut Leveque, CHU-Bordeaux, Avenue de Magellan 33604, Pessac Cedex, France

    W. Ben-Ali & T. Modine

  4. Quebec Heart and Lung Institute, Laval University, Quebec City, Canada

    J. Rodès-Cabeau

  5. Heart Valve Center Mainz, Universitätsmedizin, Mainz, Germany

    R. S. von Bardeleben

  6. Department of Cardiology, University Hospital of Galway, Galway, Ireland

    D. Mylotte

  7. Cardiovascular Research Foundation, CRF Skirball Center for Innovation, Columbia University Medical Center, New York, USA

    J. Granada

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  1. W. Ben-Ali
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Correspondence to T. Modine.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of Interest

Thomas Modine is a consultant for Boston Scientific, Medtronic, Edwards, Microport, GE, and Abbott; and he received a research support grant from Edwards. Darren Mylotte is a consultant for Medtronic, Boston Scientific, and Microport. Dr. Ralph Stephan von Bardeleben is a consultant for Abbott, Boston Scientific, Cardiac Dimensions, Edwards Lifesciences, and Medtronic. Walid Ben Ali, Reda Ibrahim, and Josep Rhodès declare no conflict of interest.

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The original online version of this article was revised: Affiliations 1 and 3 contain some typos and Dr. Modine was not affiliated to 3.

This article is part of the Topical Collection on Structural Heart Disease

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Ben-Ali, W., Ibrahim, R., Rodès-Cabeau, J. et al. Transcatheter Mitral Valve Implantation Systematic Review: Focus on Transseptal Approach and Mitral Annulus Calcification. Curr Cardiol Rep 23, 37 (2021). https://doi.org/10.1007/s11886-021-01466-7

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  • DOI: https://doi.org/10.1007/s11886-021-01466-7

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