pp 1-15 | Cite as

Percutaneous Mitral Valve Interventions and Heart Failure

Chapter
First Online:
Part of the Advances in Experimental Medicine and Biology book series

Abstract

Mitral regurgitation (MR) is the most frequent Valvular Heart Disease (VHD) and is an important cause of heart failure. MR can be caused by primary valve abnormality (Degenerative MR/Primary MR) or it can be secondary to cardiomyopathy (Functional MR/Secondary MR). Medical management alleviates symptoms but does not alter the progression of the disease. Current guidelines recommend surgery for moderate-to-severe (Grade > 3) MR in patients with symptoms or evidence of left ventricular dysfunction. Despite current practice guidelines, the majority of patients with severe MR do not undergo surgery. The reasons include high surgical risk from advanced age or multiple comorbidities, and a lack of clear data supporting valve surgery for secondary MR with LV dysfunction. The recent emergence of percutaneous interventional approaches in treating MR has expanded therapeutic options for patients who are at high risk for conventional Mitral Valve (MV) surgery. In this chapter, we will review the novel advancements in the field of percutaneous MV interventions that could potentially become the standard of care for patients with MR and heart failure.

Keywords

Mitral regurgitation Heart failure Percutaneous mitral valve intervention Leaflet repair MitraClip Chordae repair Direct annuloplasty Left ventricle remodeling Transcatheter mitral valve replacement 
This is a preview of subscription content, log in to check access

Notes

Conflict of Interest

None.

References

  1. Abdul-Jawad Altisent O, Dumont E, Dagenais F et al (2015) Initial experience of transcatheter mitral valve replacement with a novel transcatheter mitral valve: procedural and 6-month follow-up results. J Am Coll Cardiol 66(9):1011–1019Google Scholar
  2. Abraham WT, Fisher WG, Smith AL, MIRACLE Study Group. Multicenter In Sync Randomized Clinical Evaluation et al (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346(24):1845–1853Google Scholar
  3. ACC/AHA guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association. J Am Coll Cardiol 1998;32:1486–1588Google Scholar
  4. Bach DS, Awais M, Gurm HS, Kohnstamm S (2009) Failure of guideline adherence for intervention in patients with severe mitral regurgitation. J Am Coll Cardiol 54:860–865Google Scholar
  5. Banai S, Jolicoeur EM, Schwartz M et al (2012) Tiara: a novel catheter-based mitral valve bioprosthesis: initial experiments and short-term pre-clinical results. J Am Coll Cardiol 60:1430–1431Google Scholar
  6. Bonow RO, Carabello BA, Chatterjee K et al (2006) ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 48(3):1–148Google Scholar
  7. Bonow RO, Carabello BA, Chatterjee K et al (2008) 2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 52(13):1–142Google Scholar
  8. Breithardt OA, Sinha AM, Schwammenthal E et al (2003) Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure. J Am Coll Cardiol 41(5):765–770Google Scholar
  9. Calafiore AM, Iaco AL, Gallina S et al (2013) Surgical treatment of functional mitral regurgitation. Int J Cardiol 166:559–571Google Scholar
  10. Capomolla S, Febo O, Gnemmi M et al (2000) Beta blockade therapy in chronic heart failure: diastolic function and mitral regurgitation improvement by carvedilol. Am Heart J 139(4):596–608Google Scholar
  11. Carabello BA (2008) The current therapy for mitral regurgitation. J Am Coll Cardiol 52:319–326Google Scholar
  12. Carabello BA (2009) Mitral valve repair in the treatment of mitral regurgitation. Curr Treat Options Cardiovasc Med 11:419–425Google Scholar
  13. Chaput M, Handschumacher MD, Tournoux F et al (2008) Mitral leaflet adaptation to ventricular remodeling: occurrence and adequacy in patients with functional mitral regurgitation. Circulation 118:845–852Google Scholar
  14. Cheung A, Stub D, Moss R, Boone RH, Leipsic J, Verheye S et al (2014) Transcatheter mitral valve implantation with Tiara bioprosthesis. EuroIntervention 10(Suppl U):U115–U119Google Scholar
  15. Cleland JG, Daubert JC, Erdmann E, Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators et al (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352(15):1539–1549Google Scholar
  16. Dal-Bianco JP, Levine RA (2013) Anatomy of the mitral valve apparatus: role of 2D and 3D echocardiography. Cardiol Clin 31:151–164Google Scholar
  17. Feldman T, Foster E, Glower DD, et al, for the EVEREST II Investigators (2011) Percutaneous repair or surgery for mitral regurgitation. N Engl J Med 364:1395–406Google Scholar
  18. Gaasch WH, Meyer TE (2008) Left ventricular response to mitral regurgitation: implications for management. Circulation 118(22):2298–2303Google Scholar
  19. Glower DD, Kar S, Trento A et al (2014) Percutaneous mitral valve repair for mitral regurgitation in high-risk patients: results of the EVEREST II study. J Am Coll Cardiol 64:172–181Google Scholar
  20. Goel SS, Bajaj N, Aggarwal B et al (2014) Prevalence and outcomes of unoperated patients with severe symptomatic mitral regurgitation and heart failure: comprehensive analysis to determine the potential role of MitraClip for this unmet need. J Am Coll Cardiol 63:185–186Google Scholar
  21. Grossi EA, Patel N, Woo YJ et al (2010) Outcomes of the RESTOR-MV trial (randomized evaluation of a surgical treatment for off-pump repair of the mitral valve). J Am Coll Cardiol 56:1984–1993Google Scholar
  22. Hammerstingl C, Schueler R, Welz A, Nickenig G (2013) Ischemic mitral regurgitation: pathomechanisms and current therapeutic options. Internist (Berl) 54:39–40Google Scholar
  23. Harnek J, Webb JG, Kuck KH et al (2011) Transcatheter implantation of the MONARC coronary sinus device for mitral regurgitation. 1-year results from the EVOLUTION phase I study (clinical evaluation of the Edwards Lifesciences percutaneous mitral Annuloplasty system for the treatment of mitral regurgitation). JACC Cardiovasc Interv 4(1):115–122Google Scholar
  24. Heuser RR, Witzel T, Dickens D, Takeda PA (2008) Percutaneous treatment for mitral regurgitation: the QuantumCor system. J Interv Cardiol 21:178–182Google Scholar
  25. Jilaihawi H et al (2010) Mitral annular reduction with subablative therapeutic ultrasound: pre-clinical evaluation of the ReCor device. EuroIntervention 6:54–62Google Scholar
  26. Jones EC, Devereux RB, Roman MJ et al (2001) Prevalence and correlates of mitral regurgitation in a population-based sample (the strong heart study). Am J Cardiol 87:298–304Google Scholar
  27. Kaul S, Spotnitz WD, Glasheen WP, Touchstone DA (1991) Mechanism of ischemic mitral regurgitation. An experimental evaluation. Circulation 84:2167–2180Google Scholar
  28. Kim JH, Kocaturk O, Ozturk C et al (2009) Mitral cerclage annuloplasty, a novel transcatheter treatment for secondary mitral valve regurgitation. Initial results in swine. J Am Coll Cardiol 54(7):638–651Google Scholar
  29. Kleber F (2012) GDS Accucinch program update, TransCatheter therapeutics 24th annual scientific symposium, Miami 2012Google Scholar
  30. Ladich E, Michaels MB, Jones RM et al (2011) Endovascular valve edge-to-edge repair study (EVEREST) investigators. Pathological healing response of explanted MitraClip devices. Circulation 123(13):1418–1427Google Scholar
  31. Lange R, Piazza N (2015) The HighLife transcatheter mitral valve implantation system. EuroIntervention 11(Suppl W):W82–W83Google Scholar
  32. Levine RA, Hung J (2003) Ischemic mitral regurgitation, the dynamic lesion: clues to the cure. J Am Coll Cardiol 42(11):1929–1932Google Scholar
  33. Lutter G, Lozonschi L, Ebner A, Gallo S, Marin Y, Kall C, Missov E et al (2014) First-in-human off-pump transcatheter mitral valve replacement. JACC Cardiovasc Interv 7:1077–1078Google Scholar
  34. Machaalany J, St-Pierre A, Sénéchal M et al (2013) Fatal late migration of viacor percutaneous transvenous mitral annuloplasty device resulting in distal coronary venous perforation. Can J Cardiol 29:130Google Scholar
  35. Madaric J, Vanderheyden M, Van Laethem C et al (2007) Early and late effects of cardiac resynchronization therapy on exercise-induced mitral regurgitation: relationship with left ventricular dyssynchrony, remodelling and cardiopulmonary performance. Eur Heart J 28(17):2134–2141Google Scholar
  36. Maisano F, Vanermen H, Seeburger J et al (2012) Direct access transcatheter mitral annuloplasty with a sutureless and adjustable device: preclinical experience. Eur J Cardiothorac Surg 42(3):524–529Google Scholar
  37. Maisano F, Franzen O, Baldus S et al (2013) Percutaneous mitral valve interventions in the real world: early and 1-year results from the ACCESSEU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol 62:1052–1061Google Scholar
  38. Maisano F, Taramasso M, Nickenig G et al (2016) Cardioband, a transcatheter surgical-like direct mitral valve annuloplasty system: early results of the feasibility trial. Eur Heart J 37(10):817–825Google Scholar
  39. Maselli D, Guarracino F, Chiaramonti F, Mangia F, Borelli G, Minzioni G (2006) Percutaneous mitral annuloplasty: an anatomic study of human coronary sinus and its relation with mitral valve annulus and coronary arteries. Circulation 114:377–380Google Scholar
  40. Mauri L, Foster E, Glower DD et al (2013) 4-year results of a randomized controlled trial of percutaneous repair versus surgery for mitral regurgitation. J Am Coll Cardiol 62:317–328Google Scholar
  41. Mirabel M, Iung B, Baron G et al (2007) What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery? Eur Heart J 28:1358–1365Google Scholar
  42. Muller DWM, Farivar RS, Jansz P, et al, on behalf of the Tendyne Global Feasibility Trial Investigators (2017) Transcatheter mitral valve replacement for patients with symptomatic mitral regurgitation: a global feasibility trial. J Am Coll Cardiol 69:381–391Google Scholar
  43. Nickenig G, Schueler R, Dager A et al (2016) Treatment of chronic functional mitral valve regurgitation with a percutaneous Annuloplasty system. J Am Coll Cardiol 67(25):2927–2936Google Scholar
  44. Nishimura RA, Otto CM, Bonow RO et al (2014) 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 63:157–185Google Scholar
  45. Noble S, Vilarino R, Muller H, Sunthorn H, Roffi M (2011) Fatal coronary sinus and aortic erosions following percutaneous transvenous mitral annuloplasty device. EuroIntervention 7:148–150Google Scholar
  46. O’Gara PT (2012) Randomized trials in moderate ischemic mitral regurgitation: many questions, limited answers. Circulation 126(21):2452–2455Google Scholar
  47. Pedersen WR, Block P, Leon M et al (2008) iCoapsys mitral valve repair system. Percutaneous implantation in an animal model. Catheter Cardiovasc Interv 72(1):125–131Google Scholar
  48. Piazza N, Bolling S, Moat N, Treede H (2014) Medtronic transcatheter mitral valve replacement. EuroIntervention 10(Suppl U):U112–U114Google Scholar
  49. Puls M, Lubos E, Boekstegers P, von Bardeleben RS et al (2016) One-year outcomes and predictors of mortality after MitraClip therapy in contemporary clinical practice: results from the German transcatheter mitral valve interventions registry. Eur Heart J 37(8):703–712Google Scholar
  50. Rahman S, Eid N, Murarka S, Heuser RR (2010) Remodeling of the mitral valve using radiofrequency energy: review of a new treatment modality for mitral regurgitation. Cardiovasc Revasc Med 11:249–259Google Scholar
  51. Raman J, Jagannathan R, Chandrashekar P, Sugeng L (2011) Can we repair the mitral valve from outside the heart? A novel extra-cardiac approach to functional mitral regurgitation. Heart Lung Circ 20:157–162Google Scholar
  52. Ray S (2010) The echocardiographic assessment of functional mitral regurgitation. Eur J Echocardiogr 11:11–17Google Scholar
  53. Sack S, Kahlert P, Bilodeau L et al (2009) Percutaneous transvenous mitral annuloplasty. Initial human experience with a novel coronary sinus implant device. Circ Cardiovasc Interv 2(4):277–284Google Scholar
  54. Saito K, Okura H, Watanabe N et al (2012) Influence of chronic tethering of the mitral valve on mitral leaflet size and coaptation in functional mitral regurgitation. J Am Coll Cardiol Img 5:337–345Google Scholar
  55. Schillinger W, Hunlich M, Baldus S et al (2013) Acute outcomes after MitraClip therapy in highly aged patients: results from the German TRAnscatheter mitral valve interventions (TRAMI) registry. EuroIntervention 9:84–90Google Scholar
  56. Schofer J, Siminiak T, Haude M et al (2009) Percutaneous mitral annuloplasty for functional mitral regurgitation results of the CARILLON mitral Annuloplasty device European Union study. Circulation 120:326–333Google Scholar
  57. Seneviratne B, Moore GA, West PD (1994) Effect of captopril on functional mitral regurgitation in dilated heart failure: a randomised double blind placebo controlled trial. Br Heart J 72(1):63–68Google Scholar
  58. Silberman S, Oren A, Klutstein MW et al (2006) Does mitral valve intervention have an impact on late survival in ischemic cardiomyopathy? Isr Med Assoc J 8:17–20Google Scholar
  59. Siminiak T, JC W, Haude M et al (2012) Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN trial. Eur J Heart Fail 14(8):931–938Google Scholar
  60. Sponga S, Bertrand OF, Philippon F et al (2012) Reversible circumflex coronary artery occlusion during percutaneous transvenous mitral annuloplasty with the Viacor system. J Am Coll Cardiol 59:288Google Scholar
  61. Swaans MJ, van der Heyden JAS (2013) Mitral valve devices. In: Rajamannan NM (ed) Cardiac Valvular Medicine. Springer, London, pp 187–209Google Scholar
  62. Trichon BH, Felker GM, Shaw LK, Cabell CH, O’Connor CM (2003) Relation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure. Am J Cardiol 91:538–543Google Scholar
  63. Ussia GP, Quadri A, Cammalleri V et al (2016) Percutaneous transfemoral-transseptal implantation of a second-generation CardiAQTM mitral valve bioprosthesis: first procedure description and 30-day follow-up. EuroIntervention 11:1126–1151Google Scholar
  64. Vahanian A, Alfieri O, Andreotti F et al (2012) Guidelines on the management of valvular heart disease. PERSPECTIVES COMPETENCY IN PATIENT CARE AND PROCEDURAL SKILLS: in an initial global feasibility trial of patients with severe MR at high surgical risk, TMVR abolished MR in 90% of cases with a low rate of major adverse events. TRANSLATIONAL OUTLOOK: larger studies with longer-term follow-up are necessary to confirm the generalizability of these observations and better characterize the utility of TMVR as an alternative to surgery for patients with severe, symptomatic MR. Eur Heart J 33:2451–2496Google Scholar
  65. Webb J, Harnek J, Munt BI et al (2006) Percutaneous transvenous mitral annuloplasty: initial human experience with device implantation in the coronary sinus. Circulation 113:851–855Google Scholar
  66. Williams JL, Toyoda Y, Ota T et al (2008) Feasibility of myxomatous mitral valve repair using direct leaflet and chordal radiofrequency ablation. J Interv Cardiol 21:547–554Google Scholar
  67. Wu AH, Aaronson KD, Bolling SF et al (2005) Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction. J Am Coll Cardiol 45:381–387Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Division of Cardiovascular MedicineMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  2. 2.Institute of Cardiovascular Research and TechnologyBrooklynUSA
  3. 3.Department of CardiologyMaimonides Medical CenterBrooklynUSA
  4. 4.Department of CardiologySt. Luke’s University Health NetworkBethlehemUSA

Personalised recommendations