Mitral implant of the Inovare transcatheter heart valve in failed surgical bioprostheses: a novel alternative for valve-in-valve procedures

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dc.citation.issue4
dc.citation.volume24
dc.contributor.authorGaia, Diego Felipe [UNIFESP]
dc.contributor.authorBraz, Ademir Massarico [UNIFESP]
dc.contributor.authorSimonato, Matheus [UNIFESP]
dc.contributor.authorDvir, Danny
dc.contributor.authorBreda, Joao Roberto [UNIFESP]
dc.contributor.authorRibeiro, Gustavo Calado
dc.contributor.authorFerreira, Carolina Baeta [UNIFESP]
dc.contributor.authorMarcondes Souza, Jose Augusto [UNIFESP]
dc.contributor.authorBuffolo, Enio [UNIFESP]
dc.contributor.authorPalma, Jose Honorio [UNIFESP]
dc.coverageOxford
dc.date.accessioned2020-07-17T14:02:23Z
dc.date.available2020-07-17T14:02:23Z
dc.date.issued2017
dc.description.abstractOBJECTIVES: Reoperative procedure for the treatment of a failed mitral bioprosthesis is associated with considerable risk. In some cases, mortality is high and might contraindicate the benefit of the procedure. The minimally invasive valve-in-valve (ViV) transcatheter mitral valve implant offers an alternative less-invasive approach, reducing morbidity and mortality. The objective of this paper was to evaluate the mitral ViV approach using the Braile Inovare prosthesis. METHODS: The transcatheter balloon-expandable Braile Inovare prosthesis was used in 12 cases. Procedures were performed in a hybrid operating room, under fluoroscopic and echocardiographic control. Through left minithoracotomy, the prostheses were implanted through the cardiac apex. Serial echocardiographic and clinical examinations were performed. Follow-up varied from 1 to 30 months. RESULTS: A total of 12 transapical mitral ViV procedures were performed. Patients had a mean age of 61.6 +/- 9.9 years and 92% were women. Mean logistic EuroSCORE was 20.1%. Successful valve implantation was possible in all cases. In one case, a right lateral thoracotomy was performed for the removal of an embolized prosthesis. There was no operative mortality. Thirty-day mortality was 8.3%. Ejection fraction was preserved after the implant (66.7%en
dc.description.abstract64.8%en
dc.description.abstractP = 0.3). The mitral gradient showed a significant reduction (11 mmHgen
dc.description.abstract6 mmHgen
dc.description.abstractP < 0.001). Residual mitral regurgitation was not present. There was no left ventricular outflow tract obstruction. CONCLUSIONS: The mitral ViV implant in a failed bioprosthesis is an effective procedure. This possibility might alter prosthesis selection in the future initial surgical prosthesis selection, favouring bioprostheses. Further large trials should explore its safety.en
dc.description.affiliationUniv Fed Sao Paulo, Div Cardiovasc Surg, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationUniv Washington, Div Cardiol, Seattle, WA 98195 USA
dc.description.affiliationPontificia Univ Catolica Campinas, Div Cardiovasc Surg, Campinas, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Div Anesthesia Pain & Intens Care, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Intervent Cardiol, Div Cardiol, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Div Cardiovasc Surg, Escola Paulista Med, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Intervent Cardiol, Div Cardiol, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent514-520
dc.identifierhttp://dx.doi.org/10.1093/icvts/ivw368
dc.identifier.citationInteractive Cardiovascular And Thoracic Surgery. Oxford, v. 24, n. 4, p. 514-520, 2017.
dc.identifier.doi10.1093/icvts/ivw368
dc.identifier.issn1569-9293
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54782
dc.identifier.wosWOS:000404043800006
dc.language.isoeng
dc.publisherOxford Univ Press
dc.relation.ispartofInteractive Cardiovascular And Thoracic Surgery
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectMitral valveen
dc.subjectCardiopulmonary bypassen
dc.subjectCardiac catheterizationen
dc.titleMitral implant of the Inovare transcatheter heart valve in failed surgical bioprostheses: a novel alternative for valve-in-valve proceduresen
dc.typeinfo:eu-repo/semantics/article
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