Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients?

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients?"

Transcription

1 Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients? David H. Adams, MD Cardiac Surgeon-in-Chief Mount Sinai Health System Marie Josée and Henry R. Kravis Professor and Chairman Department of Cardiovascular Surgery Icahn School of Medicine at Mount Sinai New York, NY

2 Disclosures: David H. Adams, MD Icahn School of Medicine at Mount Sinai has royalty agreements with Edwards Lifesciences and Medtronic: Physio II Mitral Annuloplasty Ring IMR ETlogix Mitral Annuloplasty Ring TriAd Tricuspid Annuloplasty Ring National Co-PI: Medtronic CoreValve US Pivotal Trial National Co-PI: NeoChord System US Pivotal Trial National Co-PI: Medtronic Apollo US Pivotal Trial

3 Minimally Invasive Mitral Surgery! Seeburger et al. Semin Thorac Cardiovasc Surg 2007;19:289

4 New Era of Truly Less Invasive MV Repair? 4 cm incision mini-left thoracotomy No cardiopulmonary bypass Apical access and totally echo guided placement of neochordae with physiologic height adjustment to eliminate MR

5 Neochordoplasty Adams et al. Eur Heart J 2010;31:

6 CAUTION: Investigational Device Limited by Federal (United States) Law to Investigational Use

7 Case 67 year old, asymptomatic Incidental finding of severe MR during work-up for hernia repair Latest echocardiogram: LVEDD 5.6cm, LVESD 4.2cm, EF 55% Referred for surgical opinion CAUTION: Investigational Device Limited by Federal (United States) Law to Investigational Use

8 Baseline TEE CAUTION: Investigational Device Limited by Federal (United States) Law to Investigational Use

9 CAUTION: Investigational Device Limited by Federal (United States) Law to Investigational Use

10 Post-Tensioning CAUTION: Investigational Device Limited by Federal (United States) Law to Investigational Use

11 Discharge TTE CAUTION: Investigational Device Limited by Federal (United States) Law to Investigational Use

12 NeoChord Worldwide Experience CE Mark December 2012 Over 600 patients have been treated worldwide

13 Colli A et al. Int J Cardiol Feb 1;204:23-8

14 Anatomical Classification TYPE A: isolated central posterior leaflet prolapse/flail TYPE B: posterior multisegment prolapse/flail TYPE C: complex prolapse (BL involvement, calcification, etc) TYPE A TYPE B TYPE C Colli A et al. Int J Cardiol Feb 1;204:23-8

15 Kaplan Meier analysis of freedom from Mitral Regurgitation (MR) 2+ at 3 months follow up in Type A, B and C groups, according to mitral valve (MV) anatomy. Colli A et al. Int J Cardiol Feb 1;204:23-8

16 FDA Pivotal Trial Design ReChord IDE Trial Roll-In Cohort Pivotal Cohort High-Risk Registry 60 Subjects Up to 3 subjects/ center 75 Subjects Conventional MV Repair NeoChord MV Repair 585 Subjects Up to 20 Centers 12 Sites screening > 40 subjects screened 27 subjects approved All Subject Eligibility Confirmed by Central Screening Committee

17 Study Administration Co-Principal Investigators: David Adams and Michael Borger Chair, Trial Executive Committee: Randolph Chitwood Chair, Central Screening Committee: Julie Swain Chair, Echo Core Laboratory: Paul Grayburn Chair, Clinical Events Committee: Scott Goldman Sponsor: NeoChord, Inc.

18 Trial Primary Endpoints Primary Safety Endpoint: Superiority analysis of the proportion of patients free from Major Adverse Events in the NeoChord group compared to the open mitral valve repair measured at POD 30 or on hospital discharge Primary Effectiveness Endpoint: Non-inferiority analysis of the proportion of patients free from moderate or severe mitral regurgitation, mitral valve replacement, or mitral valve reintervention in the NeoChord group compared to the open mitral valve repair group at 1 year

19 Inclusion Criteria Inclusion Criteria Guideline indication for isolated surgical mitral valve repair for prolapse Candidate for either treatment strategy including mitral valve repair with cardiopulmonary bypass Isolated segmental prolapse of the A2 or P2 segment and anterior leaflet covers at least 65% of anterior-posterior annular distance

20 Exclusion Criteria Exclusion Criteria (selected) Other cardiac valve disease that requires intervention or prior mitral valve surgery Active endocarditis or endocarditis within 3 months (90 days) of the scheduled index procedure Coronary artery disease that requires intervention or treatment or has had coronary artery disease that required intervention or treatment within 3 months (90 days) of the scheduled index procedure Atrial Fibrillation that requires surgical intervention

21 High-Risk Registry Cohort Inclusion Criteria High operative risk or not a candidate for conventional mitral valve repair on cardiopulmonary bypass but otherwise meets pivotal trial inclusion criteria

22 High-Risk Registry Cohort Exclusion Criteria (selected) Hemodynamic instability defined as systolic pressure < 90mm Hg without afterload reduction or cardiogenic shock or the need for inotropic support or intra-aortic balloon pump Need for emergent surgery for any reason Life expectancy of less than 2 years (24 months)

23 The Harpoon Device FACILITATES Image-guided Placement and Anchoring of eptfe Neochords ENABLES Real-time Titration of Neochords on the Beating Heart and Maximization of Coaptation

24 The Harpoon Device Low-profile (8 F) Delivery System Preformed eptfe Knot Knot Formed on Atrial Surface of Mitral Leaflet Secure Anchoring of eptfe Suture to Leaflet

25 The Harpoon Procedure

26 The Harpoon Device

27 Patient #1: IntraOp TEE eptfe neochords tightened Trace MR

28 Gammie JS et al. Circulation Jul 19;134(3):189-97

29 Transcatheter Chords: Clinical Challenges Mitral Valve Other Disease Marginal Leaflet Coaptation Mitral Annular Dilatation Adjacent Clefts or Billowing Concomitant 3+/4+ TR Concomitant Atrial Fibrillation

30 Borderline Coaptation

31 Asymmetric MV Annular Dilatation Annular dilatation at A3P3 area, other than flail segment location

32 Adjacent Clefts

33 Complex Anatomy

34 Concomitant TR

35 Take Home Points Truly minimally invasive MV repair therapy Feasible with stable results in anatomically appropriate patients Pivotal trials comparing outcomes to open surgery will tell the story

36 Thank You

Repair or Replacement

Repair or Replacement Surgical intervention post MitraClip Device: Repair or Replacement Saudi Heart Association, February 21-24 Rüdiger Lange, MD, PhD Nicolo Piazza, MD, FRCPC, FESC German Heart Center, Munich, Germany Division

More information

Transcatheter Echo Guided Mitral Valve Repair with NeoChord Implantation: Results from NeoChord Independent International Registry

Transcatheter Echo Guided Mitral Valve Repair with NeoChord Implantation: Results from NeoChord Independent International Registry Transcatheter Echo Guided Mitral Valve Repair with NeoChord Implantation: Results from NeoChord Independent International Registry A. Colli, E. Bizzotto, E. Manzan, L. Besola, F. Zucchetta, D.Pittarello,

More information

Percutaneous Mitral Valve Repair: What Can We Treat and What Should We Treat

Percutaneous Mitral Valve Repair: What Can We Treat and What Should We Treat Percutaneous Mitral Valve Repair: What Can We Treat and What Should We Treat Innovative Procedures, Devices & State of the Art Care for Arrhythmias, Heart Failure & Structural Heart Disease October 8-10,

More information

Worldwide Results and Review of MitraClip : What Is the Future?

Worldwide Results and Review of MitraClip : What Is the Future? Worldwide Results and Review of MitraClip : What Is the Future? Darío Echeverri, M.D., F.A.C.C. Disclosure Information The following relationships exist: Consultant: Medtronic, Abbott Vascular Off label

More information

Percutaneous Mitral Valve Repair

Percutaneous Mitral Valve Repair Percutaneous Mitral Valve Repair MitraClip: Procedure, Data, Patient Selection Chad Rammohan, MD FACC Director, Cardiac Cath Lab El Camino Hospital Mountain View, California Mitral Regurgitation MitraClip

More information

Transcatheter Mitral Innovations, Part II. Michael Mack, M.D. Baylor Scott & White Health

Transcatheter Mitral Innovations, Part II. Michael Mack, M.D. Baylor Scott & White Health Transcatheter Mitral Innovations, Part II Michael Mack, M.D. Baylor Scott & White Health Conflict of Interest Disclosure Co-PI of the COAPT Trial of MitraClip sponsored by Abbott Vascular Uncompensated

More information

Catheter-based mitral valve repair MitraClip System

Catheter-based mitral valve repair MitraClip System Percutaneous Mitral Valve Repair: Results of the EVEREST II Trial William A. Gray MD Director of Endovascular Services Associate Professor of Clinical Medicine Columbia University Medical Center The Cardiovascular

More information

Get Ready for Percutaneous Mitral Valve Approaches

Get Ready for Percutaneous Mitral Valve Approaches Get Ready for Percutaneous Mitral Valve Approaches Paul A. Grayburn, MD Baylor Scott and White Healthcare System The Heart Hospital Baylor Plano and Baylor Heart and Vascular Hospital Dallas, TX HOPE Unmet

More information

The Cardiac Surgeon of the Future

The Cardiac Surgeon of the Future The Cardiac Surgeon of the Future Gorav Ailawadi, MD Chief, Section of Adult Cardiac Surgery Professor, Surgery & Biomedical Engineering Director, Minimally Invasive Cardiac Surgery July 19, 2017 Disclosures

More information

Mitral Regurgitation

Mitral Regurgitation Mitral Regurgitation Focus on Percutaneous Repair Steven J. Yakubov, MD FACC FSCAI System Chief, Structural Heart Diseaese, OhioHealth John H. McConnell Chair of Advanced Structural Heart Disease Medical

More information

Bicuspid Aortic Valve Repair with Lansac Style Ring Without Root Reimplantation

Bicuspid Aortic Valve Repair with Lansac Style Ring Without Root Reimplantation Bicuspid Aortic Valve Repair with Lansac Style Ring Without Root Reimplantation Joseph E. Bavaria, MD Roberts-Measey Professor and Vice Chief of Cardiovascular Surgery Director, Thoracic Aortic Surgery

More information

Excellence in Care of Mitral Regurgitation: Centers of Excellence & Physician Competence

Excellence in Care of Mitral Regurgitation: Centers of Excellence & Physician Competence Excellence in Care of Mitral Regurgitation: Centers of Excellence & Physician Competence Vinay Badhwar, MD University of Pittsburgh UPMC Disclosures None Chair, STS Public Reporting Task Force ACC Evolving

More information

Treatment of severe tricuspid regurgitation: the surgeon's point of view

Treatment of severe tricuspid regurgitation: the surgeon's point of view Treatment of severe tricuspid regurgitation: the surgeon's point of view Mauro Rinaldi MD SC Cardiochirurgia U Universita degli Studi di Torino Direttore: Prof. M. Rinaldi Introduction Right-sided cardiac

More information

Echocardiographic Evaluation of Primary Mitral Regurgitation

Echocardiographic Evaluation of Primary Mitral Regurgitation Echocardiographic Evaluation of Primary Mitral Regurgitation Roberto M Lang, MD 0-10 o ME 4CH Med A2 P2 50-70 o Commissural P3 P1 A2 80-100 o ME 2CH P3 A2 A1 A1 125-135 o - ME Long axis P2 A2 P3 A3 P2

More information

8/31/2016. Mitraclip in Matthew Johnson, MD

8/31/2016. Mitraclip in Matthew Johnson, MD Mitraclip in 2016 Matthew Johnson, MD 1 Abnormal Valve Function Valve Stenosis Obstruction to valve flow during that phase of the cardiac cycle when the valve is normally open. Hemodynamic hallmark - pressure

More information

Minimally Invasive Mitral Valve Surgery: Not Another Flash in the Pan The MUSC Experience

Minimally Invasive Mitral Valve Surgery: Not Another Flash in the Pan The MUSC Experience Minimally Invasive Mitral Valve Surgery: Not Another Flash in the Pan The MUSC Experience MUSC Minimally Invasive Cardiac Surgery Mario Castillo- Sang, MD Assistant Professor of Surgery Division of Cardiothoracic

More information

Transcatheter Aortic Valve Replacement: Current and Future Devices: How do They Work, Eligibility, Review of Data

Transcatheter Aortic Valve Replacement: Current and Future Devices: How do They Work, Eligibility, Review of Data Transcatheter Aortic Valve Replacement: Current and Future Devices: How do They Work, Eligibility, Review of Data Echo Florida 2013 Jonathan J. Passeri, M.D. Co-Director, Heart Valve Program Director,

More information

MEMO 3D RECHORD. Ready to repair. Guiding standards in Mitral valve repair

MEMO 3D RECHORD. Ready to repair. Guiding standards in Mitral valve repair MEMO 3D RECHORD TM Ready to repair Guiding standards in Mitral valve repair CARDIAC SURGERY SOLUTIONS A 45-year long history of innovative records in cardiac surgery LivaNova s relentless commitment to

More information

Introducing the COAPT Trial

Introducing the COAPT Trial physician INFORMATION Eligible patients Symptomatic functional mitral regurgitation 3+ Not suitable candidates for open mitral valve surgery NYHA functional class II, III, or ambulatory IV Introducing

More information

The FORMA Early Feasibility Study: 30-Day Outcomes of Transcatheter Tricuspid Valve Therapy in Patients with Severe Secondary Tricuspid Regurgitation

The FORMA Early Feasibility Study: 30-Day Outcomes of Transcatheter Tricuspid Valve Therapy in Patients with Severe Secondary Tricuspid Regurgitation The FORMA Early Feasibility Study: 30-Day Outcomes of Transcatheter Tricuspid Valve Therapy in Patients with Severe Secondary Tricuspid Regurgitation Susheel Kodali, MD Director, Structural Heart & Valve

More information

MitraClip in the ICCU: Which Patient will Benefit?

MitraClip in the ICCU: Which Patient will Benefit? MitraClip in the ICCU: Which Patient will Benefit? DAVID MEERKIN STRUCTURAL A ND CONGENITAL HEART DISEASE UNIT SHAARE ZEDEK MEDICAL CENTER JERUSALEM Conflict of Interest No relevant disclosures Complex

More information

MitraClip. Brian Whisenant, MD. December 2015

MitraClip. Brian Whisenant, MD. December 2015 MitraClip Brian Whisenant, MD December 2015 Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement or affiliation with the

More information

Article. Reference. Is minimally invasive mitral valve repair with artificial chords reproducible and applicable in routine surgery?

Article. Reference. Is minimally invasive mitral valve repair with artificial chords reproducible and applicable in routine surgery? Article Is minimally invasive mitral valve repair with artificial chords reproducible and applicable in routine surgery? PANOS, Aristotelis, et al. Abstract Traditional resectional techniques and chordal

More information

Update on Percutaneous Therapies for Structural Heart Disease. William Thomas MD Director of Structural Heart Program Tucson Medical Center

Update on Percutaneous Therapies for Structural Heart Disease. William Thomas MD Director of Structural Heart Program Tucson Medical Center Update on Percutaneous Therapies for Structural Heart Disease William Thomas MD Director of Structural Heart Program Tucson Medical Center NCVH 2014- Tucson Disclosure of Financial Interest Research: Stock

More information

Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement?

Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Original Article Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Hiroaki Sakamoto, MD, PhD, and Yasunori Watanabe, MD, PhD Background: Recently, some articles

More information

Outcomes in the Commercial Use of Self-expanding Prostheses in Transcatheter Aortic Valve Replacement: A Comparison of the Medtronic CoreValve and

Outcomes in the Commercial Use of Self-expanding Prostheses in Transcatheter Aortic Valve Replacement: A Comparison of the Medtronic CoreValve and Outcomes in the Commercial Use of Self-expanding Prostheses in Transcatheter Aortic Valve Replacement: A Comparison of the Medtronic CoreValve and Evolut R platforms in the Society of Thoracic Surgeons/American

More information

Recurrent mitral regurgitation after repair: Should the mitral valve be re-repaired?

Recurrent mitral regurgitation after repair: Should the mitral valve be re-repaired? Surgery for Acquired Cardiovascular Disease Recurrent mitral regurgitation after repair: Should the mitral valve be re-repaired? Rakesh M. Suri, MD, DPhil, Hartzell V. Schaff, MD, Joseph A. Dearani, MD,

More information

Mitral Valve Disease, When to Intervene

Mitral Valve Disease, When to Intervene Mitral Valve Disease, When to Intervene Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Current ACC/AHA guideline Stages

More information

MitraClip World Wide Commercial Experience

MitraClip World Wide Commercial Experience MitraClip World Wide Commercial Experience Valves Repaired. Lives Improved. Carlos G. Hernandez, MBA Sr. Product Manager, Strategic Planning Abbott Vascular October, 2014 MitraClip Transcatheter Mitral

More information

Clinical material and methods. Fukui Cardiovascular Center, Fukui, Japan

Clinical material and methods. Fukui Cardiovascular Center, Fukui, Japan Mitral Valve Regurgitation after Atrial Septal Defect Repair in Adults Shohei Yoshida, Satoshi Numata, Yasushi Tsutsumi, Osamu Monta, Sachiko Yamazaki, Hiroyuki Seo, Takaaki Samura, Hirokazu Ohashi Fukui

More information

Percutaneous Therapy for Mitral Regurgitation: Current and Future Options: Could we do better today?

Percutaneous Therapy for Mitral Regurgitation: Current and Future Options: Could we do better today? Percutaneous Therapy for Mitral Regurgitation: Current and Future Options: Could we do better today? Peter S. Fail, MD, FACC, FACP, FSCAI Director of the Cardiac Catheterization Laboratories and Interventional

More information

Mitral valve infective endocarditis (IE) is the most

Mitral valve infective endocarditis (IE) is the most Mitral Valve Replacement for Infective Endocarditis With Annular Abscess: Annular Reconstruction Gregory J. Bittle, MD, Murtaza Y. Dawood, MD, and James S. Gammie, MD Mitral valve infective endocarditis

More information

Update on a Tethered Transapical Device for TMVR Vinay Badhwar, MD

Update on a Tethered Transapical Device for TMVR Vinay Badhwar, MD Update on a Tethered Transapical Device for TMVR Vinay Badhwar, MD Gordon F. Murray Professor and Chairman Department of Cardiovascular & Thoracic Surgery WVU Heart and Vascular Institute West Virginia

More information

The clinical problem of atrioventricular valve regurgitation

The clinical problem of atrioventricular valve regurgitation Mitral Regurgitation in Congenital Heart Defects: Surgical Techniques for Reconstruction Richard G. Ohye Mitral valve regurgitation (MR) is an important source of morbidity and mortality worldwide. While

More information

Latest therapies for patients with HF. Dr AIGUL BALTABAEVA PhD, FESC, FRCP RBHT & ASPH

Latest therapies for patients with HF. Dr AIGUL BALTABAEVA PhD, FESC, FRCP RBHT & ASPH Latest therapies for patients with HF Dr AIGUL BALTABAEVA PhD, FESC, FRCP RBHT & ASPH ESC HF Guidelines 2016 ESC HF Guidelines 2016: Pharmacological Treatments Pathways blocked by ACE-I, ARB and NI Effect

More information

What echo measurements are key prior to MitraClip?

What echo measurements are key prior to MitraClip? APHP CHU Bichat - Claude Bernard What echo measurements are key prior to MitraClip? Eric Brochet,MD Cardiology Department Hopital Bichat Paris France No disclosure Conflict of interest Case 69 y.o man

More information

Cover Page. The handle holds various files of this Leiden University dissertation.

Cover Page. The handle  holds various files of this Leiden University dissertation. Cover Page The handle http://hdl.handle.net/1887/20135 holds various files of this Leiden University dissertation. Author: Braun, Jerry Title: Surgical treatment of functional mitral regurgitation Issue

More information

Surgery For Ebstein Anomaly

Surgery For Ebstein Anomaly Surgery For Ebstein Anomaly Christian Pizarro, MD Chief, Pediatric Cardiothoracic Surgery Director, Nemours Cardiac Center Alfred I. dupont Hospital for Children Professor of Surgery and Pediatrics Sidney

More information

Medical Technology. A Toolbox Will Be Needed to Treat Mitral Valve Disease: Repair and Replacement. Medical Technology. BMO Top 15 List Member

Medical Technology. A Toolbox Will Be Needed to Treat Mitral Valve Disease: Repair and Replacement. Medical Technology. BMO Top 15 List Member January 4, 2017 Medical Technology A Toolbox Will Be Needed to Treat Mitral Valve Disease: Repair and Replacement Bottom Line: In September 2015 we wrote a deep dive report on transcatheter mitral valve

More information

A near 100% repair rate for mitral valve prolapse is achievable in a reference center: Implications for future guidelines

A near 100% repair rate for mitral valve prolapse is achievable in a reference center: Implications for future guidelines A near 100% repair rate for mitral valve prolapse is achievable in a reference center: Implications for future guidelines Javier G. Castillo, MD, Anelechi C. Anyanwu, MD, Valentin Fuster, MD, PhD, and

More information

Ischemic Mitral Valve Disease: Repair, Replace or Ignore?

Ischemic Mitral Valve Disease: Repair, Replace or Ignore? Ischemic Mitral Valve Disease: Repair, Replace or Ignore? Fabio B. Jatene Full Professor of Cardiovascular Surgery, Medical School, University of São Paulo, Brazil DISCLOSURE I have no financial relationship

More information

Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV?

Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV? Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV? Samin K Sharma, MD, FACC, FSCAI Director Clinical & Interventional

More information

Steven F Bolling Professor of Cardiac Surgery University of Michigan

Steven F Bolling Professor of Cardiac Surgery University of Michigan Optimal Treatment of Functional MR Steven F Bolling Professor of Cardiac Surgery University of Michigan Functional MR Functional MR in Ischemia Badhwar, Bolling, chapter in: Advances in Heart Failure,

More information

Barlow s disease is a common cause of mitral regurgitation. Large Annuloplasty Rings Facilitate Mitral Valve Repair in Barlow s Disease

Barlow s disease is a common cause of mitral regurgitation. Large Annuloplasty Rings Facilitate Mitral Valve Repair in Barlow s Disease Large Annuloplasty Rings Facilitate Mitral Valve Repair in Barlow s Disease David H. Adams, MD, Ani C. Anyanwu, MD, Parwis B. Rahmanian, MD, Vivian Abascal, MD, Sacha P. Salzberg, MD, and Farzan Filsoufi,

More information

TRANSCATHETER MITRAL VALVE IMPLANTATION FOR SEVERE MITRAL REGURGITATION: THE TENDYNE GLOBAL FEASIBILITY TRIAL 1 YEAR OUTCOMES

TRANSCATHETER MITRAL VALVE IMPLANTATION FOR SEVERE MITRAL REGURGITATION: THE TENDYNE GLOBAL FEASIBILITY TRIAL 1 YEAR OUTCOMES TRANSCATHETER MITRAL VALVE IMPLANTATION FOR SEVERE MITRAL REGURGITATION: THE TENDYNE GLOBAL FEASIBILITY TRIAL 1 YEAR OUTCOMES David WM Muller, MBBS, MD St Vincent s Hospital, Sydney On behalf of the Tendyne

More information

Biatrial Maze or PVI to Ablate Afib? Marc Gillinov, MD

Biatrial Maze or PVI to Ablate Afib? Marc Gillinov, MD Biatrial Maze or PVI to Ablate Afib? Marc Gillinov, MD Disclosures Consultant/Speaker AtriCure Medtronic CryoLife Edwards Abbott Research Funding Abbott Equity Interest Clear Catheter Cleveland Clinic

More information

Bicuspid Aortic Valve Repair in the Setting of Severe Aortic Insufficiency

Bicuspid Aortic Valve Repair in the Setting of Severe Aortic Insufficiency Bicuspid Aortic Valve Repair in the Setting of Severe Aortic Insufficiency Edward P. Chen MD Director Thoracic Aortic Surgery Division of Cardiothoracic Surgery Emory University School of Medicine Atlanta,

More information

2017 Update to the AHA/ACC Guideline for Management of Mitral Valve Disease

2017 Update to the AHA/ACC Guideline for Management of Mitral Valve Disease 2017 Update to the AHA/ACC Guideline for Management of Mitral Valve Disease Patrick T. O Gara, MD BWH Heart and Vascular Center Professor of Medicine, Harvard Medical School Disclosures NHLBI CTSN Co-chair

More information

New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor. Cardiothoracic Radiology

New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor. Cardiothoracic Radiology New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor Cardiothoracic Radiology Disclosure I have no disclosure pertinent to this presentation.

More information

TAVR in 2020: What is Next!!!!

TAVR in 2020: What is Next!!!! TAVR in 2020: What is Next!!!! Vinod H. Thourani, MD Professor of Surgery Chairman, Department of Cardiac Surgery Medstar Heart and Vascular Institute Washington Hospital Center Washington, DC Disclosures

More information

Mitral Regurgitation Epidemiology and Classification

Mitral Regurgitation Epidemiology and Classification Subject: Transcatheter Mitral Valve Repair Page: 1 of 23 Last Review Status/Date: December 2015 Transcatheter Mitral Valve Repair Description Transcatheter mitral valve repair is a potential alternative

More information

ICE: Echo Core Lab-CRF

ICE: Echo Core Lab-CRF APPENDIX 1 ICE: Echo Core Lab-CRF Study #: - Pt Initials: 1. Date of study: / / D D M M M Y Y Y Y 2. Type of Study: TTE TEE 3. Quality of Study: Poor Moderate Excellent Ejection Fraction 4. Ejection Fraction

More information

NON SURGICAL TREATMENT OF CARDIAC DISEASE PETER J SABIA, MD FACC ASSOCIATES IN CARDIOLOGY SILVER SPRING, MARYLAND

NON SURGICAL TREATMENT OF CARDIAC DISEASE PETER J SABIA, MD FACC ASSOCIATES IN CARDIOLOGY SILVER SPRING, MARYLAND NON SURGICAL TREATMENT OF CARDIAC DISEASE PETER J SABIA, MD FACC ASSOCIATES IN CARDIOLOGY SILVER SPRING, MARYLAND TOPICS ATRIAL SEPTAL DEFECT VSD IHSS PERCUTANEOUS AORTIC VALVE PERCUTANEOUS MITRAL VALVE

More information

Ischemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications

Ischemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications Surgery for Acquired Cardiovascular Disease Ischemic mitral valve reconstruction and replacement: Comparison of long-term survival and complications Eugene A. Grossi, MD Judith D. Goldberg, ScD Angelo

More information

Asymptomatic Valvular Disease:

Asymptomatic Valvular Disease: Asymptomatic Valvular Disease: Can Echocardiography Help You Decide When to Intervene? Neil J. Weissman, MD MedStar Health Research Inst at MedStar Washington Hospital Center & Professor of Medicine Georgetown

More information

Ischemic mitral regurgitation (IMR) is an insufficiency of

Ischemic mitral regurgitation (IMR) is an insufficiency of Repair Techniques for Ischemic Mitral Regurgitation Damien J. LaPar, MD, MSc, and Irving L. Kron, MD Ischemic mitral regurgitation (IMR) is an insufficiency of the mitral valve (MV) secondary to myocardial

More information

Understanding the guidelines for Interventions in MR. Ali AlMasood

Understanding the guidelines for Interventions in MR. Ali AlMasood Understanding the guidelines for Interventions in MR Ali AlMasood Mitral regurgitation The most diverse from all acquired valve diseases About 50% of patients with an LVEF 35 percent had moderate to severe

More information

I have financial relationships to disclose Honoraria from: Edwards

I have financial relationships to disclose Honoraria from: Edwards I have financial relationships to disclose Honoraria from: Edwards Mitral Valve Annuloplasty in Ischemic Mitral regurgitation Jean François Avierinos Hôpital Timone Marseille August 28, 2012 Ischemic MR

More information

DISCLOSURE. Mitral ViV: why? Mitral Valve- in- Valve: Procedural Image Guidance with TEE, a Must Have or Nice to Have? UW Medicine NONE.

DISCLOSURE. Mitral ViV: why? Mitral Valve- in- Valve: Procedural Image Guidance with TEE, a Must Have or Nice to Have? UW Medicine NONE. Mitral Valve- in- Valve: Procedural Image Guidance with TEE, a Must Have or Nice to Have? G. Burkhard Mackensen, MD, PhD, FASE Professor & Chief, Division of Cardiothoracic Anesthesia, Department of Anesthesiology

More information

Status Of The MitraClip: Trials (EVEREST II & COAPT) & FDA

Status Of The MitraClip: Trials (EVEREST II & COAPT) & FDA Status Of The MitraClip: Trials (EVEREST II & COAPT) & FDA Ted Feldman, M.D., FSCAI FACC FESC Evanston Hospital SCAI Fall Fellows Course Las Vegas, Nevada December 8 11 th, 2013 Ted Feldman MD, FACC, FESC,

More information

Echo Week - Learning Objectives

Echo Week - Learning Objectives Echo Week - Learning Objectives Sunday, February 25 5-7 pm Physics Review Moderator: Mark Taylor, MD 1. Understand the ultrasound physics and apply it to image creation and optimization 2. Infer the interaction

More information

Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation

Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation Circ J 2018; 82: 93 101 doi: 10.1253/circj.CJ-17-0380 ORIGINAL ARTICLE Cardiovascular Surgery Effect of Recurrent Mitral Regurgitation After Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation

More information

Development of a TMVR Device Challenge to Innovators

Development of a TMVR Device Challenge to Innovators Development of a TMVR Device Challenge to Innovators Eberhard Grube MD, FACC, FSCAI, FAPSIC University Bonn, Heart Center, Bonn, Germany Stanford Universuty, School of Medicine, Palo Alto, CA Disclosure

More information

Igor Palacios, MD Director of Interventional Cardiology Massachusetts General Hospital Professor of Medicine Harvard Medical School

Igor Palacios, MD Director of Interventional Cardiology Massachusetts General Hospital Professor of Medicine Harvard Medical School Aortic Stenosis: Current State of Percutaneous Therapies, Emerging Technologies and Future Directions Igor Palacios, MD Director of Interventional Cardiology Massachusetts General Hospital Professor of

More information

MITRAL VALVE DISEASE- ASSESSMENT AND MANAGEMENT. Irene Frantzis P year, SGUL Sheba Medical Center

MITRAL VALVE DISEASE- ASSESSMENT AND MANAGEMENT. Irene Frantzis P year, SGUL Sheba Medical Center MITRAL VALVE DISEASE- ASSESSMENT AND MANAGEMENT Irene Frantzis P year, SGUL Sheba Medical Center MITRAL VALVE DISEASE Mitral Valve Regurgitation Mitral Valve Stenosis Mitral Valve Prolapse MITRAL REGURGITATION

More information

Nimesh D. Desai, M.D., Ph.D. Director, Thoracic Aortic Surgery Research Program University of Pennsylvania

Nimesh D. Desai, M.D., Ph.D. Director, Thoracic Aortic Surgery Research Program University of Pennsylvania Nimesh D. Desai, M.D., Ph.D. Director, Thoracic Aortic Surgery Research Program University of Pennsylvania Primarily Expert/pioneer series from 5 10 groups No RCTs, limited controls and rapidly changing

More information

Revolutionizing how advanced heart disease is treated. Alexei Marko, CEO Chris Clark, CFO November 2014

Revolutionizing how advanced heart disease is treated. Alexei Marko, CEO Chris Clark, CFO November 2014 Revolutionizing how advanced heart disease is treated Alexei Marko, CEO Chris Clark, CFO November 2014 Forward-Looking Statements Statements contained herein that are not based on historical or current

More information

TAVR for low-risk patients in 2017: not so fast.

TAVR for low-risk patients in 2017: not so fast. TAVR for low-risk patients in 2017: not so fast. Enrico Ferrari, MD, FETCS Cardiac Surgery Department Cardiocentro Ticino Foundation Lugano, Switzerland Conflicts of Interest Consultant and proctor for

More information

Treatment of Inter-MitraClip Regurgitation Due to Posterior Leaflet Cleft by Use of The Amplatzer Vascular Plug II device

Treatment of Inter-MitraClip Regurgitation Due to Posterior Leaflet Cleft by Use of The Amplatzer Vascular Plug II device Volume 1, Issue 3 Case Report ISSN: 2572-9292 Treatment of Inter-MitraClip Regurgitation Due to Posterior Leaflet Cleft by Use of The Amplatzer Vascular Plug II device Neha M. Mantri, Gagan D. Singh, Thomas

More information

16 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900

16 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900 CLINICAL COMMUNIQUé 6 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 69 The Carpentier-Edwards PERIMOUNT Mitral Pericardial Valve, Model 69, was introduced into clinical

More information

Transcatheter mitral valve repair is considered investigational in all situations.

Transcatheter mitral valve repair is considered investigational in all situations. 2.02.30 Transcatheter Mitral Valve Repair Section 2.0 Medicine Subsection 2.02 Cardiology Description Effective Date September 30, 20114 Original Policy Date September 30, 2014 Next Review Date September

More information

Intraoperative Echo: When to go Back on Pump

Intraoperative Echo: When to go Back on Pump Intraoperative Echo: When to go Back on Pump Madhav Swaminathan, MD, FASE Professor of Anesthesiology Division of Cardiothoracic Anesthesia & Critical Care Duke University School of Medicine Disclosures

More information

You Won t Believe What I Saw on. Disclosures. Goals. Dimensions 2013 October 18 th Michael Pfeiffer, MD. No Financial Disclosures

You Won t Believe What I Saw on. Disclosures. Goals. Dimensions 2013 October 18 th Michael Pfeiffer, MD. No Financial Disclosures You Won t Believe What I Saw on that ECHO! Dimensions 2013 October 18 th Michael Pfeiffer, MD Disclosures No Financial Disclosures Goals Review unusual and unique echocardiographic images. Briefly present

More information

Valvular Imaging Optimizing Data Acquisition and Interpretation

Valvular Imaging Optimizing Data Acquisition and Interpretation Valvular Imaging Optimizing Data Acquisition and Interpretation Suhny Abbara, MD Director Cardiovascular Imaging Section, Massachusetts General Hospital Assistant Professor, Harvard Medical School Sabbara@Partners.org

More information

Correction of anterior mitral prolapse: The parachute technique

Correction of anterior mitral prolapse: The parachute technique Correction of anterior mitral prolapse: The parachute technique Konstantinos Zannis, MD, a Laurens Mitchell-Heggs, MD, a Valentina Di Nitto, MD, a Matthias E. W. Kirsch, MD, PhD, b Milena Noghin, MD, a

More information

Mitral Gradients and Frequency of Recurrence of Mitral Regurgitation After Ring Annuloplasty for Ischemic Mitral Regurgitation

Mitral Gradients and Frequency of Recurrence of Mitral Regurgitation After Ring Annuloplasty for Ischemic Mitral Regurgitation Mitral Gradients and Frequency of Recurrence of Mitral Regurgitation After Ring Annuloplasty for Ischemic Mitral Regurgitation Matthew L. Williams, MD, Mani A. Daneshmand, MD, James G. Jollis, MD, John

More information

CoreValve Evolut R Technology review and Clinical Results. Paul TL Chiam

CoreValve Evolut R Technology review and Clinical Results. Paul TL Chiam CoreValve Evolut R Technology review and Clinical Results Paul TL Chiam MBBS (S pore), MMed, MRCP (UK), FAMS FRCP (Edin), FESC (EU), FACC (USA), FSCAI (USA) Cardiologist Mount Elizabeth Hospital Singapore

More information

Regurgitant Lesions. Bicol Hospital, Legazpi City, Philippines July Gregg S. Pressman MD, FACC, FASE Einstein Medical Center Philadelphia, USA

Regurgitant Lesions. Bicol Hospital, Legazpi City, Philippines July Gregg S. Pressman MD, FACC, FASE Einstein Medical Center Philadelphia, USA Regurgitant Lesions Bicol Hospital, Legazpi City, Philippines July 2016 Gregg S. Pressman MD, FACC, FASE Einstein Medical Center Philadelphia, USA Aortic Insufficiency Valve anatomy and function LVOT and

More information