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Trans-Catheter Interventional Treatment of Structural Heart Diseases

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The High-risk Surgical Patient

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Abstract

Transcatheter valve interventions have transformed the management of valvular heart disease, especially for elderly patients and patients at high surgical risk mainly affected by severe aortic stenosis or mitral regurgitation. The development of transcatheter valve treatment can certainly be considered one of the most fascinating examples of successful translational research in medicine. Thanks to an outstanding partnership between multidisciplinary clinicians and engineers we moved from concept to bench, bench to bedside, bedside to clinical feasibility trial and finally to Guideline, leading to a breakthrough technology with durable impact on the pattern of medical practice. With the continuous development of better delivery systems, devices, new approaches and new implantation strategies, transcatheter valve treatment has become much simpler and safer. The indications initially limited to elderly patients with multiple co-morbidities progressively evolved and now include a broader population of patients with low surgical risk, degenerated surgical bioprosthesis, and even patients with other valvular diseases such as mitral and tricuspid disease.

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References

  1. Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, Capodanno D, Conradi L, De Bonis M, De Paulis R, Delgado V, Freemantle N, Gilard M, Haugaa KH, Jeppsson A, Jüni P, Pierard L, Prendergast BD, Sádaba JR, Tribouilloy C, Wojakowski W, ESC/EACTS Scientific Document Group; ESC Scientific Document Group. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2021:ehab395. https://doi.org/10.1093/eurheartj/ehab395.

  2. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, Derumeaux G, Anselme F, Laborde F, Leon MB. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002;106(24):3006–8.

    Article  PubMed  Google Scholar 

  3. Davies H. Catheter mounted valve for temporary relief of aortic insufficiency. Lancet. 1965;1

    Google Scholar 

  4. Cribier A, Savin T, Saoudi N, Rocha P, Berland J, Letac B. Percutaneous transluminal valvuloplasty of acquired aortic stenosis in elderly patients: an alternative to valve replacement? Lancet. 1986;1:63–7.

    Article  CAS  PubMed  Google Scholar 

  5. Lal P, Upasani P, Kanwar S, Parihar A, Arora R, Grube E, Laborde JC. First-in-man experience of percutaneous aortic valve replacement using self-expanding corevalve prosthesis. Indian Heart J. 2011;63(3):241–4.

    PubMed  Google Scholar 

  6. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363(17):1597–607.

    Article  CAS  PubMed  Google Scholar 

  7. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187–98.

    Article  CAS  PubMed  Google Scholar 

  8. Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014;370(19):1790–8.

    Article  CAS  PubMed  Google Scholar 

  9. Webb JG, Doshi D, Mack MJ, Makkar R, Smith CR, Pichard AD, et al. A randomized evaluation of the SAPIEN XT transcatheter heart valve system in patients with aortic stenosis who are not candidates for surgery. JACC Cardiovasc Interv. 2015;8(14):1797–806.

    Article  PubMed  Google Scholar 

  10. Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374(17):1609–20.

    Article  CAS  PubMed  Google Scholar 

  11. Herrmann HC, Thourani VH, Kodali SK, Makkar RR, Szeto WY, Anwaruddin S, et al. One-year clinical outcomes with SAPIEN 3 transcatheter aortic valve replacement in high-risk and inoperable patients with severe aortic stenosis. Circulation. 2016;134(2):130–40.

    Article  PubMed  Google Scholar 

  12. Mack MJ, Leon MB, Thourani VH, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380:1695–705. https://doi.org/10.1056/NEJMoa1814052.

    Article  PubMed  Google Scholar 

  13. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, O’Gara PT, Ruiz CE, Skubas NJ, Sorajja P, Sundt TM 3rd, Thomas JD, American College of Cardiology/American Heart Association Task Force on Practice G. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(22):e57–185.

    Article  PubMed  Google Scholar 

  14. Deeb GM, Reardon MJ, Chetcuti S, Patel HJ, Grossman PM, Yakubov SJ, Kleiman NS, Coselli JS, Gleason TG, Lee JS, Hermiller JB Jr, Heiser J, Merhi W, Zorn GL 3rd, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Maini B, Mumtaz M, Conte J, Resar J, Aharonian V, Pfeffer T, Oh JK, Qiao H, Adams DH, Popma JJ, CoreValve USCI. 3-Year outcomes in high-risk patients who underwent surgical or transcatheter aortic valve replacement. J Am Coll Cardiol. 2016;67:2565–74.

    Article  PubMed  Google Scholar 

  15. Thourani VH, Kodali S, Makkar RR, Herrmann HC, Williams M, Babaliaros V, Smalling R, Lim S, Malaisrie SC, Kapadia S, Szeto WY, Greason KL, Kereiakes D, Ailawadi G, Whisenant BK, Devireddy C, Leipsic J, Hahn RT, Pibarot P, Weissman NJ, Jaber WA, Cohen DJ, Suri R, Tuzcu EM, Svensson LG, Webb JG, Moses JW, Mack MJ, Miller DC, Smith CR, Alu MC, Parvataneni R, D’Agostino RB Jr, Leon MB. Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis. Lancet. 2016;387:2218–25.

    Article  PubMed  Google Scholar 

  16. Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, Sondergaard L, Mumtaz M, Adams DH, Deeb GM, Maini B, Gada H, Chetcuti S, Gleason T, Heiser J, Lange R, Merhi W, Oh JK, Olsen PS, Piazza N, Williams M, Windecker S, Yakubov SJ, Grube E, Makkar R, Lee JS, Conte J, Vang E, Nguyen H, Chang Y, Mugglin AS, Serruys PW, Kappetein AP, Investigators SURTAVI. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2017;376:1321–31.

    Article  PubMed  Google Scholar 

  17. Siontis GCM, Overtchouk P, Cahill TJ, Modine T, Prendergast B, Praz F, Pilgrim T, Petrinic T, Nikolakopoulou A, Salanti G, Sondergaard L, Verma S, Juni P, Windecker S. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis. Eur Heart J. 2019;40:3143–53.

    Article  PubMed  Google Scholar 

  18. Leon MB, Mack MJ, Hahn RT, Thourani VH, Makkar R, Kodali SK, Alu MC, Madhavan MV, Chau KH, Russo M, Kapadia SR, Malaisrie SC, Cohen DJ, Blanke P, Leipsic JA, Williams MR, McCabe JM, Brown DL, Babaliaros V, Goldman S, Herrmann HC, Szeto WY, Genereux P, Pershad A, Lu M, Webb JG, Smith CR, Pibarot P, PARTNER 3 Investigators. Outcomes 2 years after transcatheter aortic valve replacement in patients at low surgical risk. J Am Coll Cardiol. 2021;77:1149–61.

    Article  PubMed  Google Scholar 

  19. Foroutan F, Guyatt GH, Otto CM, et al. Structural valve deterioration after transcatheter aortic valve implantation. Heart. 2017;103:1899–905.

    Article  PubMed  Google Scholar 

  20. Bruschi G, Fratto P, De Marco F, et al. The trans-subclavian retrograde approach for transcatheter aortic valve replacement: single-center experience. J Thorac Cardiovasc Surg. 2010;140:911–5.

    Article  PubMed  Google Scholar 

  21. Petronio AS, De Carlo M, Bedogni F, et al. Safety and efficacy of the subclavian approach for transcatheter aortic valve implantation with the CoreValve revalving system. Circ Cardiovasc Interv. 2010;3:359–66.

    Article  PubMed  Google Scholar 

  22. Bruschi G, De Marco F, Fratto P, et al. Direct aortic access through right minithoracotomy for implantation of self-expanding aortic bioprosthetic valves. J Thorac Cardiovasc Surg. 2010;140:715–7.

    Article  PubMed  Google Scholar 

  23. Bruschi G, De Marco F, Botta L, et al. Direct transaortic CoreValve implantation through right mini-thoracotomy in patients with patent coronary grafts. Ann Thorac Surg. 2012;93:1297–9.

    Article  PubMed  Google Scholar 

  24. Hayashidaa K, Romano M, Lefèvre T, et al. The transaortic approach for transcatheter aortic valve implantation: a valid alternative to the transapical access in patients with no peripheral vascular option. A single center experience. Eur J Cardiothorac Surg. 2013;44:692–700.

    Article  Google Scholar 

  25. Azmoun A, Amabile N, Ramadan R, Ghostine S, Caussin C, Fradi S, Raoux F, Brenot P, Nottin R, Deleuze P. Transcatheter aortic valve implantation through carotid artery access under local anaesthesia. Eur J Cardiothorac Surg. 2014;46(4):693–8. https://doi.org/10.1093/ejcts/ezt619; discussion 698. Epub 2014 Jan 14

    Article  PubMed  Google Scholar 

  26. Ye J, Cheung A, Lichtenstein SV, et al. Transapical aortic valve implantation in humans. J Thorac Cardiovasc Surg. 2006;131:1194–6.

    Article  PubMed  Google Scholar 

  27. D'Auria F, Casado AP, Myat A, Lorusso R, Hildick-Smith D. Long-term survival and outcomes according to VARC-2 criteria for subclavian, direct aortic, femoral, and apical implantation: an 8-year United Kingdom TAVI surgical experience. Surg Technol Int. 2020;37:245–52.

    PubMed  Google Scholar 

  28. Greenbaum AB, O’Neill WW, Paone G, et al. Caval-aortic access to allow transcatheter aortic valve replacement in otherwise ineligible patients: initial human experience. J Am Coll Cardiol. 2014;63:2795–804.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Biasco L, Ferrari E, Pedrazzini G, Faletra F, Moccetti T, Petracca F, Moccetti M. Access sites for TAVI: patient selection criteria, technical aspects, and outcomes. Front Cardiovasc Med. 2018;5:88. https://doi.org/10.3389/fcvm.2018.00088. eCollection 2018

    Article  PubMed  PubMed Central  Google Scholar 

  30. Alfieri O, De Bonis M, Lapenna E, Regesta T, Maisano F, Torracca L, La Canna G. “Edge-to-edge” repair for anterior mitral leaflet prolapse. Semin Thorac Cardiovasc Surg. 2004;16:182–7.

    Article  PubMed  Google Scholar 

  31. Kalbacher D, Schäfer U, Bardeleben RS, Eggebrecht H, Sievert H, Nickenig G, Butter C, May AE, Bekeredjian R, Ouarrak T, Kuck KH, Plicht B, Zahn R, Baldus S, Ince H, Schillinger W, Boekstegers P, Senges J, Lubos E. Long-term outcome, survival and predictors of mortality after MitraClip therapy: results from the German transcatheter mitral valve interventions (TRAMI) registry. Int J Cardiol. 2019;277:35–41. https://doi.org/10.1016/j.ijcard.2018.08.023. Epub 2018 Aug 10.

    Article  PubMed  Google Scholar 

  32. Stone GW, Lindenfeld J, Abraham WT, Kar S, Lim DS, Mishell JM, Whisenant B, Grayburn PA, Rinaldi M, Kapadia SR, Rajagopal V, Sarembock IJ, Brieke A, Marx SO, Cohen DJ, Weissman NJ, Mack MJ, COAPT Investigators. Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med. 2018;379(24):2307–18. https://doi.org/10.1056/NEJMoa1806640. Epub 2018 Sep 23.

    Article  PubMed  Google Scholar 

  33. Obadia JF, Messika-Zeitoun D, Leurent G, Iung B, Bonnet G, Piriou N, Lefèvre T, Piot C, Rouleau F, Carrié D, Nejjari M, Ohlmann P, Leclercq F, Saint Etienne C, Teiger E, Leroux L, Karam N, Michel N, Gilard M, Donal E, Trochu JN, Cormier B, Armoiry X, Boutitie F, Maucort-Boulch D, Barnel C, Samson G, Guerin P, Vahanian A, Mewton N, MITRA-FR Investigators. Percutaneous repair or medical treatment for secondary mitral regurgitation. N Engl J Med. 2018;379(24):2297–306. https://doi.org/10.1056/NEJMoa1805374. Epub 2018 Aug 27.

    Article  PubMed  Google Scholar 

  34. Lim DS, Kar S, Spargias K, Kipperman RM, O'Neill WW, Ng MKC, Fam NP, Walters DL, Webb JG, Smith RL, Rinaldi MJ, Latib A, Cohen GN, Schäfer U, Marcoff L, Vandrangi P, Verta P, Feldman TE. Transcatheter valve repair for patients with mitral regurgitation: 30-day results of the clasp study. JACC Cardiovasc Interv. 2019;12(14):1369–78. https://doi.org/10.1016/j.jcin.2019.04.034. Epub 2019.

    Article  PubMed  Google Scholar 

  35. Seeburger J, Rinaldi M, Nielsen SL, Salizzoni S, Lange R, Schoenburg M, Alfieri O, Borger MA, Mohr FW, Aidietis A. Off-pump transapical implantation of artificial neo-chordae to correct mitral regurgitation: the TACT Trial (Transapical Artificial Chordae Tendinae) proof of concept. J Am Coll Cardiol. 2014;63(9):914–9. https://doi.org/10.1016/j.jacc.2013.07.090. Epub 2013 Sep 24.

    Article  PubMed  Google Scholar 

  36. Gammie JS, Bartus K, Gackowski A, D’Ambra MN, Szymanski P, Bilewska A, Kusmierczyk M, Kapelak B, Rzucidlo-Resil J, Moat N, Duncan A, Yadev R, Livesey S, Diprose P, Gerosa G, D'Onofrio A, Pitterello D, Denti P, La Canna G, De Bonis M, Alfieri O, Hung J, Kolsut P. Beating-heart mitral valve repair using a novel ePTFE Cordal implantation device: a prospective trial. J Am Coll Cardiol. 2018;71(1):25–36. https://doi.org/10.1016/j.jacc.2017.10.062. Epub 2017 Nov 1.

    Article  PubMed  Google Scholar 

  37. Witte KK, Lipiecki J, Siminiak T, Meredith IT, Malkin CJ, Goldberg SL, Stark MA, von Bardeleben RS, Cremer PC, Jaber WA, Celermajer DS, Kaye DM, Sievert H. The REDUCE FMR trial: a randomized sham-controlled study of percutaneous mitral annuloplasty in functional mitral regurgitation. JACC Heart Fail. 2019;7(11):945–55. https://doi.org/10.1016/j.jchf.2019.06.011. Epub 2019 Sep 11.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiac Surgery, ASST Grande Ospedale Metropolitano Niguarda, Niguarda Hospital, Milan, Italy

    Giuseppe Bruschi

  2. Department of Cardiac Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Bruno Merlanti, Aldo Cannata & Claudio F. Russo

Authors
  1. Giuseppe Bruschi
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  2. Bruno Merlanti
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  3. Aldo Cannata
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  4. Claudio F. Russo
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Correspondence to Giuseppe Bruschi .

Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Paolo Aseni

  2. Divisione di Cardiochirurgia, IRCCS Fondazione Policlinico San Matteo, Pavia, Pavia, Italy

    Antonino Massimiliano Grande

  3. Div. of Emerg. Surg., Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland

    Ari Leppäniemi

  4. Department of Pathophysiology and Transplantation, General Surgery and Trauma Team, University of Milano, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Osvaldo Chiara

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Bruschi, G., Merlanti, B., Cannata, A., Russo, C.F. (2023). Trans-Catheter Interventional Treatment of Structural Heart Diseases. In: Aseni, P., Grande, A.M., Leppäniemi, A., Chiara, O. (eds) The High-risk Surgical Patient. Springer, Cham. https://doi.org/10.1007/978-3-031-17273-1_20

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  • DOI: https://doi.org/10.1007/978-3-031-17273-1_20

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