Interventions for valvular disease and heart failure - Mini-focus on transcatheter mitral valve replacement

Anterior mitral leaflet modification with endoscopic scissors during Tendyne implantation

EuroIntervention 2023;19:742-743. DOI: 10.4244/EIJ-D-23-00426

Kerstin Piayda
Kerstin Piayda1, MD, MSc; Mani Arsalan1,2, MD; Peter Roth3, MD; Oliver Dörr1, MD; Christian Hamm1, MD; Holger Nef1, MD; Andreas Böning3, MD
1. Department of Cardiology and Vascular Medicine, Medical Faculty, Justus-Liebig-University Giessen, Giessen, Germany; 2. Department of Cardiothoracic Surgery, Medical Faculty, Goethe-University Frankfurt, Frankfurt, Germany; 3. Department of Cardiovascular Surgery, Medical Faculty, Justus-Liebig-University Giessen, Giessen, Germany
A 73-year-old woman presented with severe mitral regurgitation and New York Heart Association (NYHA) Class IV symptoms. The patient was discussed in our Heart Team and deemed inoperable due to frailty and high surgical risk (Society of Thoracic Surgeons [STS] score: 15.1%). Transoesophageal echocardiography (TOE) showed severe mitral valve regurgitation with a diminutive posterior mitral valve leaflet and consecutive restricted leaflet motion (Moving image 1). An edge-to-edge repair was therefore not considered, but analysis of a full cardiac cycle by computed tomography depicted suitability for Tendyne (Abbott) implantation. Computational modelling revealed a high risk of left ventricular outflow tract obstruction (LVOTO) due ...

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