Transcatheter mitral valve replacement to treat rheumatic mitral stenosis: a case series.

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Frontiers in Cardiovascular Medicine Pub Date : 2024-12-05 eCollection Date: 2024-01-01 DOI:10.3389/fcvm.2024.1424105
Ping Jin, Hong Guo, Yu Mao, Mengen Zhai, Yang Liu, Jian Yang
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引用次数: 0

Abstract

Background: Rheumatic mitral stenosis (RMS) is a common valvular heart disease in developing countries. We sought to evaluate the early experience of patients with RMS undergoing transcatheter mitral valve replacement (TMVR).

Methods: In this retrospective study, a total of 5 RMS patients accepted TMVR. All patients underwent computed tomography and echocardiography before having the procedure. After the preprocedural comprehensive evaluations, the surgeons planned to use the Prizvalve (a novel balloon-expandable transcatheter aortic valve system which is now under the clinical registration study) for TMVR. Clinical data were collected at baseline, before discharge, and at the 30-day follow-up.

Results: The median age of the 5 RMS patients was 61 years (range 60-77 years); 60% were male, and the median Society of Thoracic Surgeons score was 13.3% (range 6.2-17.1%). TMVR was successful in all patients. Postoperative transesophageal echocardiography showed that 60.0% (n = 3) of the patients had no paravalvular leakage and 40.0% (n = 2) had trace paravalvular leakage. The median postoperative peak velocity decreased to 1.4 m/s (range 1.1-1.7 m/s), and the median pressure gradient decreased to 3 mmHg (range 2-3 mmHg). No deaths occurred at the 30-day follow-up, and all patients had an improvement of ≥1 on the New York Heart Association functional rating.

Conclusions: Our early experience with TMVR in RMS patients suggests that it is a safe and feasible procedure. The early results of the procedure are acceptable and provide bright prospects and directions for the precision treatment of RMS.

Clinical trial registration: ClinicalTrials.gov, identifier (NCT02917980).

经导管二尖瓣置换术治疗风湿性二尖瓣狭窄:一个病例系列。
背景:风湿性二尖瓣狭窄(RMS)是发展中国家常见的瓣膜性心脏病。我们试图评估RMS患者接受经导管二尖瓣置换术(TMVR)的早期经验。方法:回顾性研究5例RMS患者接受TMVR。所有患者术前均行计算机断层扫描和超声心动图检查。在术前综合评估后,外科医生计划使用Prizvalve(一种新型球囊可扩张经导管主动脉瓣系统,目前正在临床注册研究中)治疗TMVR。在基线、出院前和30天随访时收集临床资料。结果:5例RMS患者的中位年龄为61岁(60-77岁);60%为男性,胸外科学会评分中位数为13.3%(范围6.2-17.1%)。所有患者的TMVR均成功。术后经食管超声心动图显示60.0% (n = 3)患者无瓣旁漏,40.0% (n = 2)患者有微量瓣旁漏。术后中位峰值流速降至1.4 m/s(范围1.1-1.7 m/s),中位压力梯度降至3 mmHg(范围2-3 mmHg)。随访30天无死亡发生,所有患者的纽约心脏协会功能评分改善≥1。结论:我们在RMS患者中应用TMVR的早期经验表明,TMVR是一种安全可行的手术。初步结果令人满意,为RMS的精密度处理提供了良好的前景和方向。临床试验注册:ClinicalTrials.gov,标识符(NCT02917980)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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