Our Summary

This research paper discusses a case where a less risky method was used to treat a heart condition called mitral regurgitation (MR), which had recurred in an 80-year old man after a previous treatment. The man had previously had an operation called a mitral annuloplasty in 2006 to treat the condition, but it had come back. Instead of repeating the operation, which carries a high risk, the doctors used a different, less invasive method called transcatheter, transapical mitral valve replacement (TMVR). The procedure was done using a device called the Tendyne system. The results showed that this method can be safe and effective, and could be a good alternative to other treatments. This could potentially reduce operation times and offer a new option for treating this condition.

FAQs

  1. What is transcatheter, transapical mitral valve replacement (TMVR)?
  2. How can TMVR be used to treat severe mitral regurgitation (MR)?
  3. What is the Tendyne system and how does it compare to other methods such as the MitraClip in-the-ring and the transcatheter aortic valve in-the-ring concept?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve replacement is to discuss the option of transcatheter, transapical mitral valve replacement (TMVR) as an alternative method to treat severe mitral regurgitation without the use of cardiopulmonary bypass. This approach can be a safe and effective option for patients who have already undergone mitral annuloplasty and are experiencing recurrent MR. It may also reduce procedural time and provide an alternative to other treatment options. It is important for patients to discuss all available options with their healthcare provider to determine the best course of action for their individual situation.

Suitable For

Patients who are typically recommended mitral valve replacement include those with severe mitral regurgitation that cannot be effectively treated with medication or less invasive procedures such as mitral valve repair. This includes patients who have recurrent MR after previous mitral valve repair procedures, as well as those who are at high risk for traditional open-heart surgery due to age, comorbidities, or other factors. Transcatheter, transapical mitral valve replacement may be considered as an alternative method in these cases, offering a less invasive approach with potentially lower risks and faster recovery times.

Timeline

  • Before mitral valve replacement:
  1. The patient undergoes mitral valve annuloplasty in 2006 to treat mitral regurgitation.
  2. Over time, the patient experiences recurrent severe mitral regurgitation, leading to symptoms such as shortness of breath, fatigue, and chest pain.
  3. The patient undergoes evaluation by a cardiac surgeon and cardiologist to determine the best treatment option.
  • After mitral valve replacement:
  1. The patient undergoes transcatheter, transapical mitral valve replacement (TMVR) using the Tendyne system in order to treat the recurrent mitral regurgitation.
  2. The procedure is performed without the use of cardiopulmonary bypass, reducing procedural time and potential risks associated with traditional open-heart surgery.
  3. The patient experiences improved symptoms and quality of life post-surgery, with a reduction in mitral regurgitation and associated complications.
  4. Regular follow-up visits and monitoring are conducted to assess the long-term success of the TMVR procedure and overall cardiac health.

What to Ask Your Doctor

  1. Can you explain why mitral valve replacement is necessary in my case?
  2. What are the potential risks and complications associated with mitral valve replacement surgery?
  3. How long is the recovery period after mitral valve replacement surgery?
  4. Will I need to take medication after the surgery, and if so, for how long?
  5. Are there any lifestyle changes I should make after mitral valve replacement surgery?
  6. How often will I need follow-up appointments after the surgery?
  7. What are the long-term outcomes and success rates of mitral valve replacement surgery?
  8. Are there any alternative treatment options to mitral valve replacement that I should consider?
  9. How experienced are you in performing mitral valve replacement surgeries?
  10. Is there anything else I should know or consider before undergoing mitral valve replacement surgery?

Reference

Authors: Damian I, Zierer A, Grund M, Kellermair J. Journal: Ann Thorac Surg. 2022 Jun;113(6):e433-e435. doi: 10.1016/j.athoracsur.2021.06.093. Epub 2021 Aug 24. PMID: 34437858