A systematic review of reported cases of combined transcatheter aortic and mitral valve interventions.
Catheter Cardiovasc Interv
; 91(1): 124-134, 2018 01 01.
Article
em En
| MEDLINE
| ID: mdl-28862381
ABSTRACT
OBJECTIVES:
To summarize the published data of combined transcatheter aortic and mitral valve intervention (CTAMVI).BACKGROUND:
CTAMVI, a combination of either transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve-in-valve (TAViV) and transcatheter mitral valve replacement (TMVR), transcatheter mitral valve-in-valve/valve-in-ring (TMViV/ViR), or percutaneous mitral valve repair (PMVR) is an attractive alternative in high-surgical risk patients with combined aortic and mitral valve disease. However, its procedural details and clinical outcomes have not been well described.METHODS:
We performed a systematic review of all the published articles from PUBMED and EMBASE.RESULTS:
A total of 37 studies with 60 patients were included. The indication for CTAMVI was high or inoperable surgical risk and symptomatic severe aortic stenosis (92%) or severe aortic regurgitation (8%) combined with moderate to severe/severe mitral stenosis (30%) or moderate/severe mitral regurgitation (65%) or both (5%). In majority of the cases, aortic valve intervention was performed prior to the mitral valve. Mortality rate were 25% for TAVR + TMVR (range 42 days to 10 months), 17% for TAVR + TMViV/ViR (range 13 days to 6 months), 0% for TAViV + TMViV/ViR (range 6-365 days), and 15% for TAVR/ViV + PMVR (range 17 days to 419 days). Significant (more than moderate) paravalvular regurgitation post-procedure was rare.CONCLUSIONS:
CTAMVI appears to confer reasonable clinical outcome. Further large study is warranted to clarify the optimal strategy, procedural details and clinical outcomes in the future.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
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Cateterismo Cardíaco
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Implante de Prótese de Valva Cardíaca
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Substituição da Valva Aórtica Transcateter
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Doenças das Valvas Cardíacas
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Valva Mitral
Tipo de estudo:
Systematic_reviews
Limite:
Adult
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Aged
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Aged80
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Catheter Cardiovasc Interv
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article