Shingo Kuwata

Transcatheter tricuspid valve repair toward a surgical standard: first-in-man report of direct annuloplasty with a cardioband device to treat severe functional tricuspid regurgitation

CardioBand™ (ValtechCardio, OrYehuda, Israel) is a transcatheter annuloplasty system designed to implant a Dacron surgical-like adjustable band with a sutureless technique under echocardiographic and fluoroscopic guidance. We describe the first-in-human clinical experience of treatment severe tricuspid regurgitation (TR) with this device. The ‘first-in-human’ patient was a 74-year-old woman with severe functional TR associated with …

In-stent protrusion after implantation of a drug-eluting stent in a honeycomb-like coronary artery structure: complete resolution over 6 months and the role of optical coherence tomography imaging in the diagnosis and follow-up.

A 61-year-old woman presented with chest pain while walking. The patient showed positive electrocardiographic findings for ischemia and slightly elevated troponin-I (0.271 ng/ml), suggesting acute coronary syndrome. Optical coherence tomography (OCT) confirmed a honeycomb-like structure with

Feasibility of concomitant MitraClip and left atrial appendage occlusion

AIMS The aim of our study is to report our single-centre experience with concomitant MitraClip (MC) and left atrial appendage occlusion (LAAO) and further to assess the feasibility, safety and short-term outcome of such an approach. METHODS AND RESULTS Twenty-five consecutive patients underwent MC with concomitant LAAO at our hospital (combined group). As a control group, 25 consecutive patients with atrial fibrillation (AF) undergoing standalone MC were selected. Baseline parameters were equal between the two groups. Patients in the combined group had longer procedural time (90.0 min vs. 66.0 min, p=0.02) and radiation time (32.0 min vs. 18.0 min, p=0.01). There were no procedural deaths. At 30 days, one patient died due to cerebral haemorrhage (combined vs. CONTROL 4% vs. 0%, p=0.32) and two had acute kidney injury (combined vs. CONTROL 4% vs. 4%, p=1.00). In multivariate analysis, the association of LAAO with device or procedural success was not significant. CONCLUSIONS LAAO along with MC in a single stage procedure is feasible. These preliminary results have to be validated in a large randomised study, in order to assess the efficacy of combined LAAO that can be expected to become evident only after longer follow-up.

Ongoing and future directions in percutaneous treatment of mitral regurgitation

ABSTRACT Introduction: Mitral regurgitation (MR) is one of the major valvular disease. Although surgical mitral valve (MV) repair is the standard of care for patients with severe MR, an unmet need exists in the management of patients with severe symptomatic MR and high surgical risk. Transcatheter MV therapies are alternative treatment option in such patients with moderate to severe and symptomatic MR. Areas covered: Literatures to direct the reader to important further reading were searched with relevant websites; www.ncbi.nlm.nih.gov/pubmed using search word ‘transcatheter mitral intervention’. Expert commentary: A variety of transcatheter techniques have emerged for the percutaneous treatment of MR. We should carefully select one or combination procedure for each patient as an ideal tailor-made transcatheter MV therapy in order to improve the outcomes.

Infective endocarditis after transcatheter aortic valve implantation with LOTUS valve

Prosthetic valve endocarditis (PVE) after transcatheter aortic valve implantation (TAVI) is a serious complication, but limited number of cases has been reported. An 84-year-old man who had performed TAVI with a 25 mm LOTUS valve (Boston Scientific, Natick, Massachusetts) for severe aortic stenosis was readmitted to our institution at 1 …

Compare and contrast tricuspid and mitral valve anatomy: interventional perspectives for transcatheter tricuspid valve therapies

Moving transcatheter valve intervention towards atrioventricular (AV) valves implies increasing complexity. Some of the knowledge that has been generated during the development of mitral devices can be applied to the tricuspid valve (TV). A deep understanding of the peculiar anatomy of the TV and of the right heart chambers, with differences and similarities between the two AV valves, is fundamental to overcoming the specific challenges related to transcatheter TV therapies. The aim of this report is to explore similarities and differences between the mitral and tricuspid valve apparatus, and their interventional implications.

Evaluation of Valtech’s transcatheter mitral valve repair device

ABSTRACT Introduction: Functional mitral regurgitation is a debilitating condition, related to worsening of functional capacity and heart failure symptomatology. Cardioband (Valtech Cardio, Or Yehuda, Israel) is a novel technology designed for transcatheter repair of the mitral valve in the treatment of functional MR. Areas covered: A brief summary to direct the reader to important further reading, relevant websites; www.valtechcardio.com. An article about this device, relevant websites; www.ncbi.nlm.nih.gov/pubmed using search word ‘Cardioband’. Expert commentary: This device has been designed to be completely implantable percutaneously in a closed beating heart fashion. The adjustability features under the beating heart and guided by echocardiography allow to provide a tailored therapy to each particular mitral valve and regurgitation condition.

How to Treat Tricuspid Valve Disease: What’s New on the Horizon?

Opinion statementTricuspid regurgitation is frequent and is most often caused by annular dilatation and leaflet tethering from adverse right ventricular remodeling in response to several disease processes (functional tricuspid regurgitation), while primary/organic tricuspid valve regurgitation is less common. Surgical intervention for tricuspid regurgitation is usually performed concomitantly to left-sided heart valve surgery. In isolated significant tricuspid regurgitation, however, many patients are left unoperated as they commonly are considered at very high or prohibitive surgical risk. Moreover, the risk versus benefit data are not as well-established as compared to other valve disease. Multiple novel transcatheter therapies have now begun to emerge with the aim to treat tricuspid regurgitation less invasively. For most new interventional procedures, current trials are designed to prove efficacy and safety. In the foreseeable future, however, patients with significant MR can likely be offered a multifaceted palette of minimally invasive transcatheter options in addition to conventional surgery, which will allow to treat more patients in need. These current developments make tricuspid valve disease and its therapy an exciting field of study.

Transcatheter mitral valve repair and replacement

Mitral regurgitation is the valvular heart disease with the highest prevalence in the Western countries, and its prevalence increases with age.1 Conventional surgery provides excellent results in the younger population free of comorbidities, but up to 50% of the patients with severe mitral regurgita

Management of Tricuspid Regurgitation: The Role of Transcatheter Therapies

Surgical treatment is the gold standard treatment of functional tricuspid regurgitation (FTR) but this carries high risks of morbidity and mortality. Percutaneous procedures are an attractive alternative to surgery for selected patients deemed to be high-risk surgical candidates. A number of tricuspid transcatheter devices have been developed to treat FTR, but at present, evidence of their efficacy and safety is scarce. Preliminary data have shown promising results, but ongoing and future studies will provide a clearer picture of the benefits of these new techniques.