Our Summary

The SAPIEN 3 is a heart valve that can be inserted into the heart without needing open-heart surgery. It’s the only one of its kind that is commercially available for people who have had previous heart surgery and have hardening (or calcification) of their heart valves. However, the results from using this valve have been mixed or poor.

The researchers of this paper outline their method for getting more consistent, successful results when using the SAPIEN 3. This involves making adjustments to the valve, its delivery system, and even the heart itself while the patient is on the operating table.

Until there are devices specifically designed for this kind of procedure, it will require a team of experts from different fields. They must meticulously plan and execute the operation and carefully manage the patient afterwards. This approach is recommended to be carried out by experienced doctors who perform a high volume of these procedures.

FAQs

  1. What is the SAPIEN 3 and what is its use in mitral valve replacement?
  2. What are the limitations of the SAPIEN 3 VIM and VIR procedures?
  3. What does the execution of VIR and VIM procedures involve until purpose-built devices are readily available?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mitral valve replacement is to follow a healthy lifestyle after the procedure, including maintaining a balanced diet, regular exercise, and avoiding smoking. This can help improve overall heart health and reduce the risk of complications. Additionally, it is important to attend regular follow-up appointments with your healthcare provider to monitor your progress and ensure the success of the mitral valve replacement.

Suitable For

Patients who are typically recommended for mitral valve replacement include those with severe mitral valve disease, such as mitral regurgitation or mitral stenosis, that is not responding well to other treatments such as medication or repair procedures. In particular, patients with previous mitral surgical rings or mitral annular calcification may be recommended for transcatheter mitral valve replacement using devices such as the SAPIEN 3. These procedures may require aggressive multidisciplinary cooperation, meticulous planning and execution, and postprocedure management by experienced, high-volume operators to achieve consistent results.

Timeline

Before Mitral Valve Replacement:

  • Patient is diagnosed with mitral valve disease, such as mitral regurgitation or stenosis
  • Patient undergoes various diagnostic tests, such as echocardiogram, to determine the severity of the condition
  • Treatment options are discussed with the patient, including the possibility of mitral valve replacement
  • Patient may undergo preoperative evaluations and preparation for the surgery

After Mitral Valve Replacement:

  • Patient undergoes the mitral valve replacement surgery, which can be done through open-heart surgery or minimally invasive techniques
  • Recovery period in the hospital, which may include monitoring in the intensive care unit
  • Rehabilitation and physical therapy to help the patient regain strength and function
  • Follow-up appointments with the healthcare team to monitor the patient’s progress and adjust medications as needed
  • Long-term management of the mitral valve replacement, including regular check-ups and potential need for additional procedures in the future.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mitral valve replacement include:

  1. What is the reason for recommending mitral valve replacement?
  2. What are the different types of mitral valve replacement procedures available?
  3. What are the potential risks and complications associated with mitral valve replacement?
  4. What is the expected recovery time after the procedure?
  5. Will I need to take medication after the surgery, and if so, for how long?
  6. What lifestyle changes will I need to make after the mitral valve replacement?
  7. How often will I need follow-up appointments after the procedure?
  8. What is the long-term outlook for someone who has undergone mitral valve replacement?
  9. Are there any alternative treatment options to mitral valve replacement that I should consider?
  10. How experienced is the medical team in performing mitral valve replacement procedures, especially in cases of valve in ring (VIR) and valve in mitral annular calcification (VIM)?

Reference

Authors: Babaliaros VC, Lederman RJ, Gleason PT, Khan JM, Kohli K, Sahu A, Rogers T, Bruce CG, Paone G, Xie JX, Kamioka N, Condado JF, Byku I, Perdoncin E, Lisko JC, Greenbaum AB. Journal: JACC Cardiovasc Interv. 2021 Oct 25;14(20):2195-2214. doi: 10.1016/j.jcin.2021.08.044. PMID: 34674861