Our Summary

This research paper is about a new method to treat severe mitral regurgitation (MR), a heart condition where the mitral valve doesn’t close properly, allowing blood to flow backward in your heart. The new procedure is called transcatheter mitral valve replacement (TMVR) and is an alternative to surgery. TMVR, however, has some challenges particularly due to the complex structure of the mitral valve.

One new device that might solve these issues is the AltaValve system. It has unique design features that may overcome most of the difficulties in replacing the mitral valve. This paper provides an overview of the current research on TMVR, discusses the challenges it faces, and explains how the AltaValve system might address these issues. It also talks about the first procedures using AltaValve.

In the opinion of experts, there are many high-risk patients with MR who are not getting enough treatment. TMVR is a rapidly developing field, and the AltaValve system is seen as a positive step forward. One of its potential benefits is that it avoids engaging with certain parts of the heart that can cause complications. However, more research is needed to see how well it works in different situations and over the long term.

FAQs

  1. What is the AltaValve system and how does it improve on previous mitral valve replacement methods?
  2. What are the main technical challenges encountered with transcatheter mitral valve replacement (TMVR)?
  3. What is the current state of research and evidence regarding the AltaValve system in TMVR?

Doctor’s Tip

A helpful tip a doctor might tell a patient about mitral valve replacement is to follow all post-operative instructions carefully, including taking prescribed medications, attending follow-up appointments, and participating in cardiac rehabilitation if recommended. It is important to listen to your body and report any new or worsening symptoms to your healthcare provider promptly. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and avoiding smoking can help support the success of the mitral valve replacement surgery.

Suitable For

Patients who are typically recommended for mitral valve replacement are those with severe mitral regurgitation who are considered high-risk for surgical intervention. These patients may have symptoms such as shortness of breath, fatigue, and fluid retention, and may have other comorbidities that make them poor candidates for open-heart surgery. Transcatheter mitral valve replacement (TMVR) may be considered as an alternative for these patients, particularly if they have anatomical limitations that make traditional surgery more challenging. The AltaValve system is a device that may be particularly beneficial for patients with complex mitral annulus geometry and potential interaction with the sub-valvular apparatus and left ventricular outflow tract. Additional research is needed to further evaluate the feasibility and efficacy of TMVR with the AltaValve system in different patient populations.

Timeline

Before Mitral Valve Replacement:

  1. Patient presents with symptoms of severe mitral regurgitation, such as shortness of breath, fatigue, and palpitations.
  2. Diagnosis of severe mitral regurgitation is confirmed through imaging tests such as echocardiography.
  3. Patient undergoes evaluation by a heart team to determine the best treatment option, which may include mitral valve repair or replacement.
  4. If deemed a candidate for transcatheter mitral valve replacement (TMVR), patient undergoes screening tests to assess anatomical suitability for the procedure.

After Mitral Valve Replacement:

  1. Patient undergoes TMVR procedure with the AltaValve system, which is designed to overcome anatomical limitations.
  2. Post-procedure, patient is monitored in the hospital for complications and to ensure the valve is functioning properly.
  3. Patient undergoes cardiac rehabilitation and follow-up appointments to monitor recovery and assess long-term outcomes.
  4. Patient experiences improvement in symptoms such as reduced shortness of breath and fatigue, leading to improved quality of life.
  5. Long-term follow-up is conducted to monitor the durability and effectiveness of the mitral valve replacement.

What to Ask Your Doctor

  1. What are the risks and benefits of mitral valve replacement compared to other treatment options?
  2. What is the success rate of mitral valve replacement surgery?
  3. How long is the recovery time after mitral valve replacement surgery?
  4. Will I need to take medication after the surgery? If so, what are the potential side effects?
  5. How often will I need follow-up appointments after the surgery?
  6. Are there any restrictions on physical activity or diet after mitral valve replacement surgery?
  7. What are the potential complications or long-term effects of mitral valve replacement surgery?
  8. How will mitral valve replacement surgery improve my quality of life?
  9. Are there any alternative treatments to mitral valve replacement that I should consider?
  10. How experienced is the medical team in performing mitral valve replacement surgery?

Reference

Authors: Alperi A, Del Val D, Ferreira-Neto AN, Bernier M, B Freitas-Ferraz A, Dagenais F, Rodés-Cabau J. Journal: Expert Rev Med Devices. 2020 Jul;17(7):627-636. doi: 10.1080/17434440.2020.1781616. Epub 2020 Jun 25. PMID: 32567388