Balloon expandable transcatheter heart valves for native mitral valve disease with severe mitral annular calcification

Mayra Guerrero, Marina Urena, Amit Pursnani, Dee D. Wang, Alec Vahanian, William O'Neill, Ted Feldman, Dominique Himbert

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Patients with mitral annular calcification (MAC) have high surgical risk for mitral valve replacement due to associated comorbidities and technical challenges related to calcium burden, precluding surgery in many patients. Transcatheter mitral valve replacement (TMVR) with the compassionate use of balloon expandable aortic transcatheter heart valves has been used in this clinical scenario. The purpose of this review was to summarize the early experience including successes and failures reported. TMVR might evolve into an acceptable alternative for selected patients with severe MAC who are not candidates for conventional mitral valve surgery. However, this field is at a very early stage and the progress will be significantly slower than the development of transcatheter aortic valve replacement due to the complexity of the mitral valve anatomy and its pathology. Optimizing patient selection process by using multimodality imaging tools to accurately measure the mitral valve annulus and evaluate the risk of left ventricular outflow tract obstruction is essential to minimize complications. Strategies for treating and preventing left ventricular outflow tract obstruction are being tested. Similarly, carefully selecting candidates avoiding patients at the end of their disease process, might improve the overall outcomes.

Original languageEnglish (US)
Pages (from-to)401-409
Number of pages9
JournalJournal of Cardiovascular Surgery
Volume57
Issue number3
StatePublished - Jun 1 2016
Externally publishedYes

Keywords

  • Balloon valvuloplasty
  • Calcification, physiologic
  • Mitral valve stenosis

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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    Guerrero, M., Urena, M., Pursnani, A., Wang, D. D., Vahanian, A., O'Neill, W., Feldman, T., & Himbert, D. (2016). Balloon expandable transcatheter heart valves for native mitral valve disease with severe mitral annular calcification. Journal of Cardiovascular Surgery, 57(3), 401-409.