Percutaneous Mitral Valve Repair. Khalil Fattouch, MD, PhD
|
|
|
- Noah Stafford
- 5 years ago
- Views:
Transcription
1 Percutaneous Mitral Valve Repair Khalil Fattouch, MD, PhD
2 J Thorac Cardiovasc Surg 1983;86:323-37
3
4
5
6 Euro Heart Survey Results:One-year survival Operated (222 pts) 96.3± 1.3% Non-operated (174 pts) 88.2± 2.5% P=0.003 Mirabel et al, European Heart J 2007; 28,
7 Euro Heart Survey Factors associated with the decision not to operate Pre-operative variables Multivariate LVEF (per 10% decrease) 0,0002 Aetiology Non-ischaemic 0,0006 Age (per 10-years increase) 0,001 Charlson comorbidity index (per 1 point increase) p 0,004 Degree of MR 0,005 Mirabel et al, European Heart J 2007; 28,
8 Euro Heart Survey Conclusions Treatments tend to be under-used in the patients who have the highest risk profile NEW TECHNOLOGY IN MR COULD HELP?
9 Transcatheter mitral interventions Ballon commissurotomy Perivalvular leak closure Annular repair Leaflet repair Transcatheter MVR
10 Transcatheter Mitral Valve Repair Opportunity Minimizing the risks while preserving clinical efficacy of surgical repair and replacement Challenges Lack of evidence and limited clinical experience
11 1-Leaflet repair: Mitraclip The Alfieri technique CE Mark approval inmarch 2008for MITRA-CLIP
12 1-Leaflet repair: Mitraclip Versatility Functional Degenerative
13 EVEREST trial II
14 The EVEREST II Randomized Controlled Trial of Percutaneous and Surgical Reduction of Mitral Regurgitation. Five-Year Results Stratified by Degenerative And Functional Etiologies Saibal Kar, MD, FACC Cedars-Sinai Medical Center, Los Angeles, CA USA On behalf of the EVEREST II Investigators
15 Patients (%) 100% 80% 60% 40% 20% 0% MitraClip Mitral Regurgitation Grade at 5 Years DMR FMR Surgery MitraClip Surgery (N=130) (N=62) (N=48) (N=18) p<0.005 p<0.005 p<0.05 p= % 100% 86% 86% % BL 5 Years BL 5 Years Patients (%) 80% 60% 40% 20% 0% BL 5 Years BL 5 Years N=85 N=34 N=21 N=7
16 NYHA Functional Class at 5 Years Patients (%) 100% 80% 60% 40% 20% 0% MitraClip Surgery (N=130) (N=62) (N=48) (N=18) p<0.005 p<0.005 p<0.05 p= % 97% 76% 100% I I II I II I III II III II IV III III BL 5 Years BL 5 Years N=85 N=36 N=21 N=6 N = survivors with paired data; p-values for descriptive purposes only DMR FMR Patients (%) 100% 80% 60% 40% 20% 0% MitraClip Surgery I II I II I III II III IV II III IV BL 5 Years BL 5 Years 23
17 Changing demographics
18 European Heart Journal doi: /eurheartj/ehs109 Guidelines on the management of valvular heart disease (version 2012) The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Authors/Task Force Members: Alec Vahanian (Chairperson) (France), Ottavio Alfieri (Chairperson) (Italy), Felicita Andreotti (Italy), Manuel J. Antunes (Portugal), Gonzalo Barón-Esquivias (Spain), Helmut Baumgartner (Germany), Michael Andrew Borger (Germany),Thierry P. Carrel (Switzerland), Michele De Bonis (Italy), Arturo Evangelista (Spain), Volkmar Falk (Switzerland), Bernard Iung (France), Patrizio Lancellotti (Belgium), Luc Pierard (Belgium), Susanna Price (UK), Hans-Joachim Schäfers (Germany), Gerhard Schuler (Germany), Janina Stepinska (Poland), Karl Swedberg (Sweden), Johanna Takkenberg (The Netherlands), Ulrich Otto Von Oppell (UK), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain), Marian Zembala (Poland) ESC Committee for Practice Guidelines (CPG): Jeroen J. Bax (Chairperson) (The Netherlands), Helmut Baumgartner (Germany), Claudio Ceconi (Italy), Veronica Dean (France), Christi Deaton (UK), Robert Fagard (Belgium), Christian Funck-Brentano (France), David Hasdai (Israel), Arno Hoes (The Netherlands), Paulus Kirchhof (United Kingdom), Juhani Knuuti (Finland), Philippe Kolh (Belgium), Theresa McDonagh (UK), Cyril Moulin (France), Bogdan A. Popescu (Romania), Željko Reiner (Croatia), Udo Sechtem (Germany), Per Anton Sirnes (Norway), Michal Tendera (Poland), Adam Torbicki (Poland), Alec Vahanian (France), Stephan Windecker (Switzerland) Document Reviewers: Bogdan A. Popescu (ESC CPG Review Coordinator) (Romania), Ludwig Von Segesser (EACTS). Review Coordinator) (Switzerland), Luigi P. Badano (Italy), Matjaž Bunc (Slovenia), Marc J. Claeys (Belgium), Niksa Drinkovic (Croatia), Gerasimos Filippatos (Greece), Gilbert Habib (France), A. Pieter Kappetein (The Netherlands), Roland Kassab (Lebanon), Gregory Y.H. Lip (UK), Neil Moat (UK), Georg Nickenig (Germany), Catherine M. Otto (USA), John Pepper, (UK), Nicolo Piazza (Germany), Petronella G. Pieper (The Netherlands), Raphael Rosenhek (Austria), Naltin Shuka (Albania), Ehud Schwammenthal (Israel), Juerg, Schwitter (Switzerland), Pilar Tornos Mas (Spain), Pedro T.Trindade (Switzerland), Thomas Walther (Germany).
19 European guidelines reccommendation for MitraClip in FMR and DMR (IIbC) Indication for treating MR Symptomatic patients despite optimal medical therapy (incl CRT). Severe MR High risk or inoperable The judgement is done by a TEAM. Life expectancy should be longer then 1 year Anatomical eligibility No guidelines on anatomical eligibility (EVEREST criteria?)
20
21 American guidelines recommendation for MitraClip : inoperable or high risk pts with DMR Optimum Value (IIbB) Limited? Value Surgical Risk Poor value: Patient Purchaser Physician Clinical Benefit Increasing age, comorbidities,lv dysf.
22 1-Leaflet repair: Mitraclip Mitra clip: Limits Optimal indications Technique is complex Incomplete reduction of MR Only early results are available No MV annulus stabilization Feldman T et al., J Am Coll Cardiol 2009;54:686-94
23 DMR Surgery remains the gold standard MitraClip is a palliative therapy for inoperable/high risk pts FMR MitraClip is becoming an option in symptomatic patients despite optimal medical therapy (including CRT).
24 2- Leaflets repair chordal adjustment -V-chordal
25 3-Leaflets repair Neochord implantation
26
27 Neochord implantation Pro Off pump correction of prolapse Beating heart adjustable of chordae Minimally invasive approach Con Limited applicability Apical attachment of the neochorda Need for annuloplasty??
28 4-Transcatheter annuloplasty
29 Transcatheter annuloplasty Coronary sinus remodeling
30 Transcatheter annuloplasty Coronary sinus remodeling
31 MONARC (Edwards) System
32 MONARC (Edwards) System EVOLUTION TRIAL
33 Carillon Mitral Contour System
34 Carillon Mitral Contour System AMADEUS TRIAL (Am J Cardiol 2009, )
35 Carillon Mitral Contour System CE approval in Europe TITAN trial (Eur J Heart Fail 2012, 14; )
36 PTMA (Viacor) Device
37 PTOLEMY trial PTMA (Viacor) Device
38 2-Transcatheter annuloplasty Coronary sinus remodeling: Limits CS to MA separation Relation of LCX and CS
39 2-Transcatheter annuloplasty Coronary sinus remodeling: Limits Limited clinical experience Coronary sinus is often superior to annulus Coronary sinus often overlies LCx artery, which can lead to acute MI Coronary sinus does not allow for complete ring annuloplasty Incomplete reduction of MR
40 Transcatheter annuloplasty Direct Annuloplasty Mitralign Direct Annuloplasty System
41
42 Transcatheter annuloplasty Direct Annuloplasty Valtech cardioband
43
44 Carillon Monarc PTMA
45 Valtech cardioband
46 Conclusions Surgery vs Percutaneous treatment Surgical mitral repair can provide excellent results in most patients Interventional MR repair is a great opportunity for expanding current treatment options Percutaneous treatment are complex procedure We need more data Only mitra clip with follow-up
47 1-Leaflet repair: Mitraclip The Alfieri technique The surgical edge-to-edge technique was first described in early 1990`s (Alfieri) Several data are reported in the literature Safe, effective, durable No occurrence of mitral stenosis Facilitates proper leaflet coaptation Degenerative - anchor flail / prolapsing leaflets Functional - Coapt tethered leaflets to reduce time and force required to close valve Creates tissue bridge
48 1-Leaflet repair: Mitraclip EVEREST Trial: Anatomic elegibility Sufficient leaflet tissue for mechanical coaptation Non-rheumatic/endocarditic valve morphology Anatomic considerations Flail gap <10mm Flail width <15mm Mitral Area > 4.0cm Coaptation length > 2mm >2mm <10mm <15mm >11mm Feldman T et al., J Am Coll Cardiol 2009;54:686-94
49 EVEREST I Endovascular Valve Edge to Edge Repair Study I
50 EVEREST cohort follow up
51 MONARC (Edwards) System MONARC delayed release system of nitinol and biodegradable specers slowly dissolved over 3-6 weeks Shortening intended to induce a conformational change in the coronary sinus, extending to the mitral annulus.
ESC / EACTS Guidelines for the Management of Valvular Heart Disease. Management of Aortic Regurgitation
ESC / EACTS Guidelines for the Management of Valvular Heart Disease Management of Aortic Regurgitation Hans-Joachim Schäfers Saarland University Medical Center, Homburg/Saar, Germany On behalf of the ESC/EACTS
La patologia valvolare dell anziano: problemi decisionali complessi. Ottavio Alfieri S.Raffaele University Hospital Milan
La patologia valvolare dell anziano: problemi decisionali complessi Ottavio Alfieri S.Raffaele University Hospital Milan 61 CONGRESSO NAZIONALE SIGG, Napoli, 2016 Bulk of Population Growth The Economist,
Mitral valve apparatus
Mitral Valvular Disease: An explosion of multiple new non-surgical options Disclosure Statement of Financial Interest Saibal Kar, MD, FACC Within the past 12 months, I or my spouse/partner have had a financial
ESSENTIAL MESSAGES FROM
ESSENTIAL MESSAGES FROM ESC GUIDELINES Committee for Practice Guidelines To improve the quality of clinical practice and patient care in Europe VHD ESC/EACTS Guidelines ON the Management OF VALVULAR HEART
Management of Patients with Mitral Regurgitation. Alec Vahanian, FESC, FRCP Bichat Hospital, Paris University Paris VII
Management of Patients with Mitral Regurgitation Alec Vahanian, FES, FRP Bichat Hospital, Paris University Paris VII Disclosures Relationship with companies who manufacture products used in the treatment
Percutaneous Mitral Valve Therapies
Percutaneous Mitral Valve Therapies Jeffrey J. Popma, MD Director, Interventional Cardiology Clinical Services Beth Israel Deaconess Medical Center Associate Professor of Medicine Harvard Medical School
Disclosure Statement of Financial Interest Saibal Kar, MD, FACC
MitraClip Therapy Saibal Kar, MD, FACC, FAHA, FSCAI Director of Interventional Cardiac Research Program Director, Interventional Cardiology Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
Percutaneous Mitral Valve Repair
Indiana Chapter of ACC November 15 th,2008 Percutaneous Mitral Valve Repair James B Hermiller, MD, FACC The Care Group, LLC St Vincent Hospital Indianapolis, IN Mechanisms of Mitral Regurgitation Mitral
Alec Vahanian,FESC, FRCP (Edin.) Bichat Hospital University Paris VII, Paris, France
Future Percutaneous Therapies for Mitral Valve Disease (Mitraclip,percutaneous annuloplasty and transcatheter valve implantation) Will they reach the TAVI s success? Alec Vahanian,FESC, FRCP (Edin.) Bichat
Prognostic Impact of FMR
Secondary Mitral Valve Regurgitation in Heart Failure, Age 60 Years From Medical Therapy to Surgical Repair to Transcatheter Intervention The Interventionalist s View Samin K Sharma, MD, FACC, FSCAI Director
Current status: Percutaneous mitral valve therapy
Current status: Percutaneous mitral valve therapy Ted Feldman, M.D., FSCAI FACC FESC Evanston Hospital ESC Stockholm 2010 Disclosures Research Grants Abbott, Edwards Consultant Abbott, Edwards 2 Percutaneous
Antiarrhythmic drug therapy for the prevention of atrial fibrillation recurrences
2012 Update of the ESC Guidelines on the Management of Atrial Fibrillation Antiarrhythmic drug therapy for the prevention of atrial fibrillation recurrences Stefan H. Hohnloser J.W. Goethe University Frankfurt
PERCUTANEOUS MITRAL VALVE THERAPIES 13 TH ANNUAL CARDIAC, VASCULAR AND STROKE CARE CONFERENCE PIEDMONT ATHENS REGIONAL
PERCUTANEOUS MITRAL VALVE THERAPIES 13 TH ANNUAL CARDIAC, VASCULAR AND STROKE CARE CONFERENCE PIEDMONT ATHENS REGIONAL DISCLOSURES I WILL BE DISCUSSING OFF-LABEL USAGE OF DEVICES RELATED TO TMVR OBJECTIVES
Eulogio Garcia MD Hospital Clínico San Carlos Madrid - Spain
Eulogio Garcia MD Hospital Clínico San Carlos Madrid - Spain Device Landscape 2010 PERCUTANEOUS TECHNIQUES Percutaneous indirect annuloplasty Percutaneous direct annuloplasty Edge to Edge ( E-Valve ) Non
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
Outline 9/17/2016. Advances in Percutaneous Mitral Valve Repair and Replacement. Scope of the Problem and Guidelines
Advances in Percutaneous Mitral Valve Repair and Replacement Scott M Lilly MD PhD, Interventional Cardiology The Ohio State University Contemporary Multidisciplinary Cardiovascular Conference Orlando,
Percutaneous mitral valve repair/replacement. Jan Van der Heyden MD, PhD St.Antonius Hospital Nieuwegein
Percutaneous mitral valve repair/replacement Jan Van der Heyden MD, PhD St.Antonius Hospital Nieuwegein Mitral Valve anatomy Difference between AoV and MV Aortic Valve Mitral Valve Transcatheter Mitral
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,
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
Euro Heart Survey New Programme Sentinel Registry Transcatheter Valve Treatment (TCVT) Carlo Di Mario, London, UK President EAPCI
Euro Heart Survey New Programme 2009-2012 Sentinel Registry Transcatheter Valve Treatment (TCVT) Carlo Di Mario, London, UK President EAPCI Alan Cribier, Rouen, France Andreas Gruentzig Award 2010 Cardiogenic
Who will Benefit from Percutaneous Management of Mitral Regurgitation? An Imaging Guide to Management
Who will Benefit from Percutaneous Management of Mitral Regurgitation? An Imaging Guide to Management James D. Thomas, M.D., F.A.C.C. Department of Cardiovascular Medicine Heart and Vascular Institute
Chapter 24: Diagnostic workup and evaluation: eligibility, risk assessment, FDA guidelines Ashwin Nathan, MD, Saif Anwaruddin, MD, FACC Penn Medicine
Chapter 24: Diagnostic workup and evaluation: eligibility, risk assessment, FDA guidelines Ashwin Nathan, MD, Saif Anwaruddin, MD, FACC Penn Medicine Mitral regurgitation, regurgitant flow between the
Mitral Valve Disease. James Hermiller, MD, FACC, FSCAI St Vincent Heart Center Indianapolis, IN
Mitral Valve Disease James Hermiller, MD, FACC, FSCAI St Vincent Heart Center Indianapolis, IN Disclosures Affiliation/Financial Relationship Consulting Fees/Honoraria Speaker Bureau Company Abbott, BSC,
Mitral regurgitation (MR) is the second most
Current Options for Mitral Annuloplasty and Leaflet Repair The benefits and limitations of today s FDA- and CE Mark approved mitral repair technologies. BY ROBERT SCHUELER, MD, AND JAN-MALTE SINNING, MD,
Transcatheter Mitral & Tricuspid Therapies. Bernard J. Zovighian Corporate Vice President
Transcatheter Mitral & Tricuspid Therapies Bernard J. Zovighian Corporate Vice President We Will Lead and Transform Treatment for Patients with Mitral and Tricuspid Diseases Mitral and Tricuspid Diseases
Percutaneous Repair for MR:
Percutaneous Repair for MR: Follow-up and longer term outcomes Ted Feldman, M.D., FSCAI FACC FESC Evanston Hospital 16th ANGIOPLASTY SUMMIT TCT Asia Pacific 2011 April 27-29 th Seoul, Korea Ted Feldman
TrattamentoTrans-catetere dell insufficienza mitralica. Francesco Bedogni. Istituto Clinico S. Ambrogio, Milano
TrattamentoTrans-catetere dell insufficienza mitralica Francesco Bedogni Severe MR Leads to Increased Hospital Admissions and Lower Survival Rates Significantly higher hospital admissions experienced by
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
Percutaneous mitral valve repair: current techniques and results
Percutaneous mitral valve repair: current techniques and results Ted Feldman, M.D., FSCAI, FACC Angioplasty Summit April 25-27 th th 2007 Seoul, Korea Ted Feldman MD, FACC, FSCAI Disclosure Information
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
Percutaneous Treatment of Valvular Heart Diseases: Lessons and Perspectives. Bernard Iung Bichat Hospital, Paris
Percutaneous Treatment of Valvular Heart Diseases: Lessons and Perspectives Bernard Iung Bichat Hospital, Paris Euro Heart Survey on Valvular Diseases 3547 Patients with Native Valve Disease n= 1250 1000
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
Transcatheter Mitral Valve Repair and Replacement: Where is the Latest Randomized Evidence Taking US Mitral-Fr, COAPT
Transcatheter Mitral Valve Repair and Replacement: Where is the Latest Randomized Evidence Taking US Mitral-Fr, COAPT and Saibal Kar, MD, FACC, FSCAI Professor of Medicine Director of Interventional Cardiac
2017 ESC/EACTS Guidelines for the management of valvular heart disease
2017 ESC/EACTS Guidelines for the management of valvular heart disease Prof. Fausto J. Pinto, FESC, FACC Immediate ESC Past President Head, Cardiology Dpt/ University Hospital Sta Maria-HPV University
When is it too late to perform transcatheter mitral valve repair? Alec Vahanian, FESC,FRCP(Edin.) Bichat hospital University Paris VII
When is it too late to perform transcatheter mitral valve repair? Alec Vahanian, FESC,FRCP(Edin.) Bichat hospital University Paris VII I, (Alec Vahanian) DO have a financial interest/arrangement or affiliation
Transcatheter Mitral Valve Interventions: Clinical Indications. Didier TCHETCHE, MD. Clinique Pasteur, Toulouse, France.
Transcatheter Mitral Valve Interventions: Clinical Indications Didier TCHETCHE, MD. Clinique Pasteur, Toulouse, France. Conflicts of interest: -Consultant for Medtronic -Consultant for Cephea Anatomy of
Reshape/Coapt: do we need more? Prof. J Zamorano Head of Cardiology University Hospital Ramon y Cajal, Madrid
Reshape/Coapt: do we need more? Prof. J Zamorano Head of Cardiology University Hospital Ramon y Cajal, Madrid Patient records 76 y.o. male Hypertension. Dyslipidemia. OPLD. Smoked in the past. Diabetes
Transcatheter Mitral Valve Repair: today and tomorrow Sponsored by Abbott. Chairperson: M. Haude Panellists: A. Al Nooryani, M.
Transcatheter Mitral Valve Repair: today and tomorrow Sponsored by Abbott Chairperson: M. Haude Panellists: A. Al Nooryani, M. Al Otaiby Session objectives To learn about the clinical patient profile for
Use of MitraClip Beyond Everest Criteria
Use of MitraClip Beyond Everest Criteria Takashi Matsumoto, MD Sendai Kousei Hospital Sendai, Japan No Disclosure of Financial Interest Introduction The efficacy and safety of the MitraClip therapy was
Contemporary Management of Mitral Regurgitation Tailoring Treatment to The Patient Subset & Clinical Situation
Contemporary Management of Mitral Regurgitation Tailoring Treatment to The Patient Subset & Clinical Situation Hatim Al Lawati MD, FRCPC, FACC Consultant Interventional Cardiology Sultan Qaboos University
Guidelines on Valvular Heart Disease (TF29) - TF Members and Additional Contributors
Guidelines on Valvular Heart Disease (TF29) - TF Members and Additional Contributors Alfieri Ottavio Andreotti Felicita Antunes Manuel J - Valtech : Mitral products (2011) - Edwards Lifesciences : Prosthetic
TREATMENT OF MITRAL REGURGITATION RAJA NAZIR FACC
TREATMENT OF MITRAL REGURGITATION RAJA NAZIR FACC NATURAL HISTORY OF MITRAL REGURGITATION Abdallah El Sabbagh et al. JIMG 2018;11:628-643 TREATMENT OPTIONS SURGERY REPAIR REPLACEMENT PERCUTANEOUS INTERVENTIONS
Percutaneous Mitral Interventions. Alec Vahanian, FESC, FRCP (Edin.) Bichat Hospital, Paris University Paris VII
Percutaneous Mitral Interventions Alec Vahanian, FESC, FRCP (Edin.) Bichat Hospital, Paris University Paris VII Rationale for Percutaneous Mitral Valve Interventions Mitral valve disease is frequent and
La Terapia Medica della Fase Cronica: dati attuali e prospettive future. Michele Senni Cardiologia 1
La Terapia Medica della Fase Cronica: dati attuali e prospettive future Michele Senni Cardiologia 1 Probability of death in Heart Failure: IN-HF Registry Cumulative one-year mortality rate 27.2% 19.2%
Percutaneous mitral annuloplasty. Francesco Maisano MD, FESC San Raffaele Hospital Milano, Italy
Percutaneous mitral annuloplasty Francesco Maisano MD, FESC San Raffaele Hospital Milano, Italy Disclosure Consultant for Abbott, Medtronic, St Jude, Edwards, ValtechCardio Founder of 4Tech Surgical techniques
VALVULOPATIE: NUOVE SOLUZIONI.
VALVULOPATIE: NUOVE SOLUZIONI www.fisiokinesiterapia.biz Nkomo, Lancet 2006 ELDERLY POPULATION PROJECTION IN USA 65-84 Years Old 85 and Older 77,2 Millions of people 34,8 4,3 30,5 53,8 6,8 47 14,3 62,9
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
Mitral valve therapy still surgical?
European Heart Journal Supplements (2015) 17 (Supplement A), A43 A48 The Heart of the Matter doi:10.1093/eurheartj/suv009 Mitral valve therapy still surgical? Khalil Fattouch 1 *, Fausto Castriota 2, Francesco
Next Generation Therapies: Aortic, Mitral and Beyond
Next Generation Therapies: Aortic, Mitral and Beyond Scott M Lilly, MD PhD Medical (Interventional) Director, Structural Heart Program Heart Summit, Lima OH August 26 th, 2017 Next Generation Therapies:
Transcatheter Mitral Valve for fmr: The Era of Too Many Options
Transcatheter Mitral Valve for fmr: The Era of Too Many Options Isaac George, M.D. Surgical Director, Structural Heart & Valve Center Assistant Professor of Surgery Columbia University Medical Center Disclosure
Χειρουργική Αντιμετώπιση της Ανεπάρκειας της Μιτροειδούς Βαλβίδας
Χειρουργική Αντιμετώπιση της Ανεπάρκειας της Μιτροειδούς Βαλβίδας Dr Χρήστος ΑΛΕΞΙΟΥ MD, PhD, FRCS(Glasgow), FRCS(CTh), CCST(UK) Consultant Cardiothoracic Surgeon Normal Mitral Valve Function Mitral Regurgitation
Device therapy in heartfailure Update of the ESC guidelines. Karl Swedberg
Device therapy in heartfailure Update of the ESC guidelines Karl Swedberg Professor of Medicine Department of emergency and cardiovascular medicine Sahlgrenska Academy University of Gothenburg, Sweden
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
Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients?
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
Index. interventional.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Ablation, of mitral leaflets, 80 Accucinch Annuloplasty system, for mitral regurgitation, 79, 94 95 Accutrak delivery system, for CoreValve
Index. B B-type natriuretic peptide (BNP), 76
Index A ACCESS-EU registry, 158 159 Acute kidney injury (AKI), 76, 88 Annular enlargement, RV, 177 178 Annuloplasty chordal cutting, 113 complete ring, 99 etiology-specific ring, 100 evolution, 98 flexible
Burden of Mitral Regurgitation (MR) in the US Why is This Important?
Secondary (Functional) Mitral Regurgitation as a Target for Heart Failure Therapy William T. Abraham, MD, FACP, FACC, FAHA, FESC, FRCP Professor of Medicine, Physiology, and Cell Biology Chair of Excellence
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
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
Repair. Commercial Products Prior authorization is recommended for Commercial Products.
Medical Coverage Policy Transcatheter Mitral Valve Repair EFFECTIVE DATE: 11 01 2018 POLICY LAST UPDATED: 06 19 2018 OVERVIEW Transcatheter mitral valve repair (TMVR) is an alternative to surgical therapy
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
Valvular Intervention
Valvular Intervention Outline Introduction Aortic Stenosis Mitral Regurgitation Conclusion Calcific Aortic Stenosis Deformed Eccentric Calcified Nodular Rigid HOSTILE TARGET difficult to displace prone
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
The Key Questions in Mitral Valve Interventions. Where Are We in 2018?
The Key Questions in Mitral Valve Interventions Where Are We in 2018? Gilles D. DREYFUS, MD, FRCS, FESC Professor of Cardiothoracic Surgery 30 GIORNATE CARDIOLOGICHE TORINESI - OCT 2018 Are guidelines
Percutaneous Treatment of Mitral Insufficiency: Present and Future
Percutaneous Treatment of Mitral Insufficiency: Present and Future Larry S. Dean, MD, MSCAI Past President SCAI Professor of Medicine and Surgery University of Washington School of Medicine Seattle, WA
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
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,
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
Imaging to select patients for Transcatheter TV
Imaging to select patients for Transcatheter TV Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands San Diego, february 2018 Research grants: Medtronic, Biotronik, Boston Scientific,
Emerging Mitral Technologies Where Are We Now? MICHAEL MACK, MD BAYLOR SCOTT & WHITE HEALTH DALLAS, TX
Emerging Mitral Technologies Where Are We Now? MICHAEL MACK, MD BAYLOR SCOTT & WHITE HEALTH DALLAS, TX Conflict of Interest Disclosure Abbott Vascular- Co PI COAPT Trial Medtronic- Executive Committee
Transcatheter Mitral Valve Repair
Protocol Transcatheter Mitral Valve Repair (20230) Medical Benefit Effective Date: 04/01/16 Next Review Date: 01/19 Preauthorization Yes Review Dates: 01/16, 01/17, 01/18 Preauthorization is required.
Ioannis Alexanian, MD, PhD Department of Cardiology General Hospital of Chest Diseases Sotiria Athens
MITRAL REGURGITATION IN PATIENT WITH SEVERE AORTIC VALVE STENOSIS Ioannis Alexanian, MD, PhD Department of Cardiology General Hospital of Chest Diseases Sotiria Athens I HAVE NOTHING TO DECLARE Management
Imaging MV. Jeroen J. Bax Leiden University Medical Center The Netherlands Davos, feb 2015
Imaging MV Jeroen J. Bax Leiden University Medical Center The Netherlands Davos, feb 2015 MV/MR: information needed on.. 1. MV anatomy 2. MR etiology - primary vs secondary 3. MR severity quantification
SURGICAL AND TRANSCATHETER MITRAL VALVE REPLACEMENT VS. REPAIR: COMPETITION OR SYNERGY
SURGICAL AND TRANSCATHETER MITRAL VALVE REPLACEMENT VS. REPAIR: COMPETITION OR SYNERGY Michael J. Reardon, M.D. Professor of Cardiothoracic Surgery Allison Family Distinguish Chair of Cardiovascular Research
Percutaneous valve procedures: an update
1 7 Percutaneous valve procedures: an update Laurens F. Tops 1 Samir R. Kapadia 2 E. Murat Tuzcu 2 Alec Vahanian 3 Ottavio Alfieri 4 John G. Webb 5 Jeroen J. Bax 1 1 Department of Cardiology, Leiden University
Conflicts of interest
Conflicts of interest Disclosure forms of all Task Force members and reviewers are available on the ESC Website http://www.escardio.org/guidelines ESC Guidelines on the diagnosis and treatment of peripheral
Primary Mitral Regurgitation
EURO VALVE Madrid News from Valves Guidelines 2012: What s new and Why? Primary Mitral Regurgitation Luc A. Pierard, MD, PhD Professor of Medicine Head of the Department of Cardiology Heart Valve Clinic,
For more information
For more information www.escardio.org/guidelines ESC Guidelines on the Prevention, Diagnosis and Treatment of Infective Endocarditis (New Version 2009)* The Task Force on the Prevention, Diagnosis and
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
My Choice For Percutaneous Mitral Valve Replacement. Jose Luis Navia, MD.
My Choice For Percutaneous Mitral Valve Replacement Jose Luis Navia, MD. Disclosure Edwards Lifescienses St. Jude Medical MAQUET NaviGate Consultant, Investigator Consultant, Investigator Consultant, Investigator
Edwards' solution for patients suffering from tricuspid valve disease
Edwards' solution for patients suffering from tricuspid valve disease R. S. von Bardeleben, MD Head Structural and Heart Valve Center Heart Center Cardiology I, University Medicine Mainz Germany Potential
Επιδιόπθωζη μιηποειδικήρ ζςζκεςήρ ζε ππόπηωζη ή πήξη γλωσίνων. Βαζίλειορ Σασπεκίδηρ Επιμεληηήρ Β Καπδιολογίαρ Γ.Ν. Παπαγεωπγίος
Επιδιόπθωζη μιηποειδικήρ ζςζκεςήρ ζε ππόπηωζη ή πήξη γλωσίνων Βαζίλειορ Σασπεκίδηρ Επιμεληηήρ Β Καπδιολογίαρ Γ.Ν. Παπαγεωπγίος MV anatomy Otto C. NEJM 2001 Leaflets anatomy 2% of population Etiology Terminology
The Changing Epidemiology of Valvular Heart Disease: Implications for Interventional Treatment Alternatives. Martin B. Leon, MD
The Changing Epidemiology of Valvular Heart Disease: Implications for Interventional Treatment Alternatives Martin B. Leon, MD Columbia University Medical Center Cardiovascular Research Foundation New
Selecting patients for percutaneous mitral valve therapy
review Selecting patients for percutaneous mitral valve therapy Patients with severe symptomatic mitral regurgitation benefit from correction of mitral regurgitation. Surgical mitral valve repair or replacement
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
Overview of Surgical Approach to Mitral Valve Disease : Why Repair? Steven F. Bolling, MD Cardiac Surgery University of Michigan
Overview of Surgical Approach to Mitral Valve Disease : Why Repair? Steven F. Bolling, MD Cardiac Surgery University of Michigan Degenerative MR is not Functional MR 2o - Functional MR : Ventricular Problem!!
Update on Transcatheter Mitral Valve Repair and Replacment
Update on Transcatheter Mitral Valve Repair and Replacment Vinod H. Thourani, MD Professor of Surgery Chair, Department of Cardiac Surgery Medstar Heart and Vascular Washington Hospital Center Georgetown
Minimally invasive therapies for the mitral valve: How will you incorporate into your clinical practice? Guilherme F.
Minimally invasive therapies for the mitral valve: How will you incorporate into your clinical practice? Guilherme F. Attizzani, MD UH Harrington Heart and Vascular Institute Interventional Cardiologist/Structural
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
Techniques innovantes pour un ttt minimal invasif : le cas de la valve mitrale
Techniques innovantes pour un ttt minimal invasif : le cas de la valve mitrale Lyon Cardiothoracic and Vascular Surgery Department Hôpital Louis Pradel LYON France Affiliation/Financial Relationship List
Treatment options in ischaemic mitral regurgitation: surgery, clips, devices?
Treatment options in ischaemic mitral regurgitation: surgery, clips, devices? Francisco Leyva Conflicts of interest: FL has received advisory board fees from Medtronic Inc, Sorin, St Jude Medical and Abbot.
Basic Principles of Degenerative Mitral Valve Repair Technical Aspects and Results. Manuel Antunes Coimbra-Portugal
Basic Principles of Degenerative Mitral Valve Repair Technical Aspects and Results Manuel Antunes Coimbra-Portugal Repair for Degenerative Disease Adams D H et al. Eur Heart J 2010;31:1958-1966 Published
CLIP ΜΙΤΡΟΕΙ ΟΥΣ: ΠΟΥ ΒΡΙΣΚΟΜΑΣΤΕ;
CLIP ΜΙΤΡΟΕΙ ΟΥΣ: ΠΟΥ ΒΡΙΣΚΟΜΑΣΤΕ; Επιµορφωτικά Σεµινάρια Ειδικευοµένων Καρδιολογίας 7 Απριλίου 2012 M Chrissoheris MD FACC THV Department HYGEIA Hospital Degenerative MR (DMR) Usually refers to an anatomic
Choosing the Right Treatment for Primary Mitral Regurgitation ΓΡΗΓΟΡΙΟΣ ΠΑΤΤΑΚΟΣ, MD, MS Καρδιοχειρουργός Β Κ/Χ Κλινικής Αναπλ. Διευθ.
Choosing the Right Treatment for Primary Mitral Regurgitation ΓΡΗΓΟΡΙΟΣ ΠΑΤΤΑΚΟΣ, MD, MS Καρδιοχειρουργός Β Κ/Χ Κλινικής Αναπλ. Διευθ. Διαδερμικών Βαλβίδων Δ.Θ.Κ.Α. «ΥΓΕΙΑ» Mitral Regurgitation Very common
Τελικά επιδιόρθωση, αντικατάσταση ή clip στην ισχαιμική ανεπάρκεια Μιτροειδούς; ΒΛΑΣΗΣ ΝΙΝΙΟΣ MD MRCP ΚΛΙΝΙΚΗ ΑΓΙΟΣ ΛΟΥΚΑΣ
Τελικά επιδιόρθωση, αντικατάσταση ή clip στην ισχαιμική ανεπάρκεια Μιτροειδούς; ΒΛΑΣΗΣ ΝΙΝΙΟΣ MD MRCP ΚΛΙΝΙΚΗ ΑΓΙΟΣ ΛΟΥΚΑΣ Carpentier MV Classification- Leaflet Mobility Normal Increased Decreased Mobility
Organic mitral regurgitation
The best in heart valve disease Organic mitral regurgitation Ewa Szymczyk Department of Cardiology Medical University of Lodz, Poland I have nothing to declare Organic mitral regurgitation leaflet abnormality
UPDATE STRUKTURELLE INTERVENTIONELLE KARDIOLOGIE
SGK Herbsttagung 17 November 2016, Aarau UPDATE STRUKTURELLE INTERVENTIONELLE KARDIOLOGIE Stephan Windecker Department of Cardiology Swiss Cardiovascular Center Bern University Hospital, Switzerland WHAT
Posterior leaflet prolapse is the most common lesion seen
Techniques for Repairing Posterior Leaflet Prolapse of the Mitral Valve Robin Varghese, MD, MS, and David H. Adams, MD Posterior leaflet prolapse is the most common lesion seen in degenerative mitral valve
Functional Mitral Regurgitation; therapeutic continuum overview. Michele Senni. Cardiologia 1 Scompenso e Trapianti di Cuore A.O. PAPA GIOVANNI XXIII
Functional Mitral Regurgitation; therapeutic continuum overview Michele Senni Cardiologia 1 Scompenso e Trapianti di Cuore A.O. PAPA GIOVANNI XXIII Functional Mitral Regurgitation FMR is not the result
Mitral valve (MV) regurgitation is common;
Update on Transcatheter Mitral Valve Repair A look at the current and soon-to-come transcatheter mitral valve repair options. BY DALE J. MURDOCH, MBBS; ROBERT H. BOONE, MD; ROBERT MOSS, MBBS; JOHN WEBB,