Transcatheter Mitral Valve Therapies

TRANSCATHETER MITRAL VALVE THERAPIES An essential survey of the advancing field of transcatheter mitral valve repair and replacement Minimally invasive transcatheter therapies have revolutionized the treatment of structural heart disease. Greatly improving outcomes for higher-risk patients, transcatheter aortic valve replacement is now established as a safe and effective alternative to invasive surgery. The mitral valve, however, poses further challenges. Contending with one of the heat’s most anatomically and pathologically complex components, practitioners and engineers have yet to perfect a stream-lined, widely deliverable therapy—though they are getting closer and closer to this goal. Transcatheter Mitral Valve Therapies provides a far-reaching survey of the field of mitral interventions in its current state. Highlighting the stumbling blocks preventing transcatheter mitral valve replacement’s widespread adoption, the book’s international group of contributors discuss the improvements to be made in repair and replacement procedures, as well as the adjunctive use of imaging and pharmacologic therapies. This ground-breaking text: Provides detailed explanations of transcatheter repair, transcatheter replacement, and adjunctive procedures Features chapters on the use of imaging to aid in patient selection, procedure planning, and intra-operative guidance Discusses the importance of minimally invasive approaches for mitral valve repair Examines anticoagulation following transcatheter mitral valve interventions Outlines the possible future of transcatheter mitral valve therapy Transcatheter Mitral Valve Therapies is an important, up-to-date resource for interventional cardiologists, as well as all clinical researchers and practitioners seeking information on this vital and developing treatment.

ranscatheter valve therapies have emerged as a viable treatments option for patients deemed high risk for conventional surgery. Whilst transcatheter aortic valve implantation (TAVI) is now established as the standard of care in high-risk aortic stenosis patients, the mitral and tricuspid frontiers have proved to be more challenging. Anatomical heterogeneity, device development, refining patient selection and until recently the absence of randomised data have all been contributing factors. For mitral regurgitation, transcatheter edge to edge repair (TEER) now benefits from positive randomised data along with significant advancements in device technology. Transcatheter mitral valve replacement (TMVR) options are also making rapid progress. More recently, tricuspid regurgitation has become the central focus of the structural heart community having previously been referred to as the “forgotten valve”

This issue of Interventional Cardiology Clinics will explore Transcatheter mitral valve repair and replacement. Curated by the series Editor-in-Chief, Dr. Matthew J. Price, this issue will cover topics and advances in the field that are relevant for practicing clinicians. This issue is one of four selected each year by Dr. Price. The volume will include articles on: Transcatheter Mitral Valve Direct Annuloplasty With the Millipede Device, Transcatheter Mitral Valve Replacement with Intrepid, Transcatheter Mitral Valve Replacement with Tendyne, Treatment of functional mitral regurgitation with transcatheter edge-to-edge repair, Transcatheter Edge-to-Edge repair for Degenerative Mitral Regurgitation, Predicting Left Ventricular Outflow Tract Obstruction Following Transcatheter Mitral Valve Replacement, Prevention and Treatment of Left Ventricular Outflow Tract Obstruction after Transcatheter Mitral Valve Replacement, and Transatrial implantation of transcatheter heart valve for mitral disease, among others.

Part of the Monographs in Cardiac Surgery Series – Introducing ‘basic science into the cardiac operating room’. Fast systematic review of small areas of cardiac surgery including up-to-date information. This will allow more rapid publication than the alternative cardiac surgery ‘tomes’. This entry into the series will provide readers with a complete review of the current understanding in mitral valve surgery and include extensive details on the diagnosis and surgical management of patients with mitral valve disease.

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The landscape of cardiac surgery is changing, as is the field of interventional cardiology. The idea of accessing and replacing a failing valve through the patients vasculature has become the most rapidly expanding therapy of choice in cardiovascular disease. Transcatheter Valve Therapies chronicles the astonishing advances that have taken place in the field and prepares readers for the challenging future of cardiac valve therapies. Designed to meet the growing needs of cardiologists, cardiac surgeons, anesthetists, and general practitioners, the book covers all aspects from logistic needs to clinical outcomes. It provides a comprehensive overview of transcatheter valve therapies and the necessary understanding for a successful clinical introduction at individual institutions. Topics include: Epidemiologic considerations Aspects of balloon aortic valvuloplasty as a stand-alone procedure or as part of the transcatheter valve replacement The history of how transcatheter valve therapies were implemented into surgical practice New imaging modalities The particularities of transcatheter access Aortic root anatomy Emerging technologies and future design improvements Development steps of aortic devices and potential solutions for transcatheter tricuspid, mitral, and pulmonary valve replacement The rigorous testing requirements for endovascular medical devices Clinical results of aortic transcatheter valve therapies in easy accessible text and table formats The future of transcatheter valve therapies All topics are discussed based on the author’s own clinical and experimental experience in the field. This volume is essential for anyone involved in transcatheter valve implantation, clinicians wishing to become more involved in improving transcatheter valve therapies, and researchers engaged in building and creating new medical technologies to shape the cardiovascular landscape of the future.

This issue of the Interventional Cardiology Clinics edited by Jason Rogers covers various approaches, techniques, and therapies for Transcatheter Mitral Value Intervention. Topics include, but are not limited to: Echocardiographic Imaging of the Mitral Valve for Transcatheter Interventions, Use of Computed Tomography to Guide Mitral Interventions, Transseptal Puncture for Mitral Interventions, MitraClip Therapy for Mitral Regurgitation: Primary MR, Coronary Sinus-Based Approach to Mitral Regurgitation, and Transcatheter Mitral Valve Replacement.

The only reference wholly dedicated to this complex topic, Diagnosis and Treatment of Mitral Valve Disease: A Multidisciplinary Approach provides authoritative, must-have information on the disease processes affecting the mitral valve, interpretation of diagnostic studies, and medical, transcatheter, and surgical treatments needed for mitral valve repair. Using a multidisciplinary approach, Drs. Scott Goldman and William Gray oversee a “who’s who team of contributing authors who offer a holistic view of the modern treatment of mitral valve disease for today’s cardiac surgeons, cardiologists, and other cardiac team members. Includes foundational chapters on anatomy and pathophysiology of the mitral valve—critically important topics when treating multiple complex and highly dynamic structures that function as a single unit. Covers diagnostic tools, medical treatments, surgical therapies, and transcatheter therapies, and provides tips for developing a successful mitral valve program (with baseline thresholds, common pitfalls, and a checklist for hospitals). Uses an accessible, quick-reference format that features takeaway chapter openers, bulleted key points, end-of-chapter summaries, a common nomenclature and glossary of terms, key references, and ample line drawings, photographs, tables, charts, and graphs throughout. Incorporates the essential role of imaging in structural transcatheter interventions, including echocardiography and transcatheter edge-to-edge repair (TEER), and their uses in diagnostic work-up, procedural planning, intra-procedural guidance, and follow-up. Features dozens of procedural videos, including transthoracic echocardiogram; cardiac MRI for mitral regurgitation; transcatheter mitral valve repair; transcatheter valvuloplasty; percutaneous mitral valve interventions; MitraClipTM positioning; and many more.