Original Scientific Article
Journal of Structural Heart Disease, April 2016, Volume 2, Issue 2:44-45
Transcatheter Mitral Valve Replacement: Update on New Devices
1 The Children’s Hospital of Philadelphia, Division of Cardiology, Philadelphia, PA, USA
2 Gorman Cardiovascular Research Group, Department of Surgery, Philadelphia, PA, USA
3 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
Transcatheter Mitral valve replacement represents the next frontier in cardiac valve therapy. This review article details the authors' experience thus far in the development of a novel catheter-based mitral valve replacement device, and also highlights the preliminary experiences of other new technologies.
Video 1An aortagram following Melody VIR, and importantly there is no aortic valve insufficiency.
Video 2A Melody valve compressed onto a delivery balloon being advanced transvenouslyacross the atrial septume and subsequently withing the “incomplete annuloplastyring”.
Video 3The Melody valve securely seated within the incomplete annuloplasty ring. There is excellent systolic fuinction and no LVOT obstruction.
Video 4This movie shows that there is no aortic valve insufficiency following Melody-in-incomplete-ring procedure. This is a very importatnt finding, because up until this point, it was generally believed that absence of a ring along the anterior leaflet would result in deformation of the aortic valve due to the mitral-to-aortic valve fibrous continuity. These experiments proved that this was indeed not true.
Video 5Color Doppler interrogation shows mild central MR, and no perivalvular leak.This video show typical results following Melody valve-in-ring mitral implantation.
Video 6A 2d image of the Melody valve and it’s relationship to the aortic valve. This video show typical results following Melody valve-in-ring mitral implantation.
Video 7LV gram post SMV replacement.
Video 8Aortagram post SMV replacement.
Video 9Left Coronary.
Video 10This movie depicts a baseline left ventriculogram in a porcine model.
Video 11The sequence of valve deployment is initiated, beginning by withdrawing the outer sheath to allow the ventricular arms of the device to blossom. Once the ventricular side is opened, the device is withdraw towards the left atrium. This “traps” the anterior and posterior leaflets of the native mitral valve between the body of the SMV device and the ventricular arms. This is important for secure anchoring in the mitral position.
Video 12Once the ventricular end of the device is set, the outer sheath is fully withdrawn, allowing the atrial side of the device to open on the LA side of the mitral annulus.
Video 13LV gram post release.
Video 14Aortagram post release.
Video 15Echo Post.
Video 16Echo Post: color
Cite this article as: Gillespie MJ, Gorman RC, Gorman III JH. Transcatheter Mitral Valve Replacement: Update on New Devices. Structural Heart Disease 2016;2(2):44-45. DOI: 10.12945/j.jshd.2016.015.14
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