“However, our results support transcatheter mitral valve-in-valve replacement as an option for most patients with failed surgical valves, independent of the patient's surgical risk. "It took us a long time to get to a transcatheter option for secondary MR. How to Cope With Mitral Valve Prolapse (MVP). The primary safety endpoint was procedural technical success, defined by the Mitral Valve Academic Research Consortium (MVARC) criteria upon exit from the hybrid suite—patient is alive with successful access, delivery, and retrieval of the delivery system; successful deployment and correct position of the first intended device; and freedom from emergency surgery or reintervention associated with the device or access procedure.
“Our data, as well as my personal experience with these patients, is that the mildly increased gradients noted after MViV are not associated with heart failure symptoms or other adverse events,” he said.Asked about the proportion of patients with degenerated bioprosthetic valves who should undergo MViV versus repeat surgery, Dvir noted that the majority of patients in this situation are relatively old.
According to MVARC, he added, the mean gradient should be below 5 mm Hg. The number of therapies and the types of patients we can treat without surgery or in conjunction with surgery is just going to keep growing."
It could be of potentially more concern. It really did help those patients," says Richardson.Results from the COAPT study showed that patients who received the MitraClip®procedure had significantly lower hospitalizations for heart failure within two years compared to those who received standard care (35.8% vs. 67.9%; p<0.001).MUSC was one of 100 centers recruiting patients for COAPT and enrollment topped out at 614 patients – not a very large recruitment goal for a national trial. "This study (COAPT) enrolled folks with heart failure who had maxed out on their medical options, but were too high risk for surgical mitral repair or replacement. Mitral valve prolapse occurs when the valve that separates the left atrium from the left ventricle bulges into the atrium when it is closed during contraction. However, the process of conducting the study was a slow endeavor and took more time to complete than other trials. Suzanne Richardson, MSN, RN, Clinical Program Manager for the Structural Heart and Valve Center at the Medical University of South Carolina (MUSC) explains, "In years past, if the patient was too high risk for surgery there was no other option and they entered a downward spiral leading to multi-organ dysfunction. What would be the rate of reintervention? The heart's weak and inefficient squeezing action cannot adequately circulate blood and can lead to multi-system organ failure.
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