PMID- 31524023
OWN - NLM
STAT- MEDLINE
DCOM- 20200413
LR  - 20200413
IS  - 1559-0879 (Electronic)
IS  - 1556-9845 (Linking)
VI  - 14
IP  - 6
DP  - 2019 Nov/Dec
TI  - Concomitant Transapical Transcatheter Aortic Valve Implantation and Transapical 
      Mitral Valve Repair With NeoChord Implantation.
PG  - 564-568
LID - 10.1177/1556984519871905 [doi]
AB  - One-third of the patients with severe symptomatic aortic valve stenosis (sAS) 
      present with hemodynamic relevant mitral valve insufficiency (rMI). In patients 
      who undergo conventional surgery, the rMI never would be left untreated; however, 
      in cases of transcatheter aortic valve implantation (TAVI), the impact of rMI is 
      often overlooked and left untreated. The combination of transapical TAVI 
      (TA-TAVI) and NeoChord implantation represents a novel, promising therapeutic 
      option for high-risk-surgery patients with sAS and rMI due to a prolapsed or 
      flailed leaflet. This case report describes 2 patients (1 male, 1 female; mean 
      age 82 years) who underwent TA-TAVI and concomitant NeoChord implantation at our 
      institute. Both presented with sAS and rMI due to a prolapse of the P2 segment of 
      the mitral valve. At first, the TA-TAVI was implanted under angio-guidance, 
      followed by three-dimensional echo-guided implantation of the NeoChords, through 
      the same approach, which was slightly posterior and lateral to the apex. TA-TAVI 
      using an Edwards Sapien 3 (26 mm, n = 1 and 29 mm, n = 1) and NeoChord 
      implantation (2 in the first and 3 in the second patient) was successful in both 
      cases. Post-intervention discharge echo indicated no paravalvular or central 
      insufficiency after the procedure and only a trace of mitral valve insufficiency. 
      TA-TAVI and concomitant NeoChord implantation is a feasible and promising 
      treatment option for high-risk patients with rMI. Despite its technical demands, 
      in experienced hands, it is a safe procedure for those not well suited for 
      surgical intervention.
FAU - Stelzmueller, Marie-Elisabeth
AU  - Stelzmueller ME
AD  - Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria.
FAU - Zilberszac, Robert
AU  - Zilberszac R
AD  - Department of Cardiology, Medical University Vienna, Vienna, Austria.
FAU - Heinrich, Nikolaus
AU  - Heinrich N
AD  - Department of Cardiothoracic Anesthesia and Intensive Care, Medical University 
      Vienna, Vienna, Austria.
FAU - Mora, Bruno
AU  - Mora B
AD  - Department of Cardiothoracic Anesthesia and Intensive Care, Medical University 
      Vienna, Vienna, Austria.
FAU - Laufer, Guenther
AU  - Laufer G
AD  - Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria.
FAU - Wisser, Wilfried
AU  - Wisser W
AD  - Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20190916
PL  - United States
TA  - Innovations (Phila)
JT  - Innovations (Philadelphia, Pa.)
JID - 101257528
SB  - IM
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/complications/diagnostic imaging/*surgery
MH  - Combined Modality Therapy/*methods
MH  - Echocardiography, Transesophageal/methods
MH  - Female
MH  - Heart Valve Prosthesis/standards
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Minimally Invasive Surgical Procedures/*methods
MH  - Mitral Valve Insufficiency/diagnostic imaging/physiopathology/*surgery
MH  - Transcatheter Aortic Valve Replacement/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - NeoChords
OT  - P2 prolapse
OT  - TAVI
OT  - aortic stenosis
OT  - mitral valve insufficiency
EDAT- 2019/09/17 06:00
MHDA- 2020/04/14 06:00
CRDT- 2019/09/17 06:00
PHST- 2019/09/17 06:00 [pubmed]
PHST- 2020/04/14 06:00 [medline]
PHST- 2019/09/17 06:00 [entrez]
AID - 10.1177/1556984519871905 [doi]
PST - ppublish
SO  - Innovations (Phila). 2019 Nov/Dec;14(6):564-568. doi: 10.1177/1556984519871905. 
      Epub 2019 Sep 16.