A systematic review of reported cases of combined transcatheter aortic and mitral valve interventions

Tomo Ando, Hisato Takagi, Alexandros Briasoulis, Tesfaye Telila, David P. Slovut, Luis Afonso, Cindy L. Grines, Theodore Schreiber

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Objectives: To summarize the published data of combined transcatheter aortic and mitral valve intervention (CTAMVI). Background: CTAMVI, a combination of either transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve-in-valve (TAViV) and transcatheter mitral valve replacement (TMVR), transcatheter mitral valve-in-valve/valve-in-ring (TMViV/ViR), or percutaneous mitral valve repair (PMVR) is an attractive alternative in high-surgical risk patients with combined aortic and mitral valve disease. However, its procedural details and clinical outcomes have not been well described. Methods: We performed a systematic review of all the published articles from PUBMED and EMBASE. Results: A total of 37 studies with 60 patients were included. The indication for CTAMVI was high or inoperable surgical risk and symptomatic severe aortic stenosis (92%) or severe aortic regurgitation (8%) combined with moderate to severe/severe mitral stenosis (30%) or moderate/severe mitral regurgitation (65%) or both (5%). In majority of the cases, aortic valve intervention was performed prior to the mitral valve. Mortality rate were 25% for TAVR+TMVR (range 42 days to 10 months), 17% for TAVR+TMViV/ViR (range 13 days to 6 months), 0% for TAViV+TMViV/ViR (range 6-365 days), and 15% for TAVR/ViV+PMVR (range 17 days to 419 days). Significant (more than moderate) paravalvular regurgitation post-procedure was rare. Conclusions: CTAMVI appears to confer reasonable clinical outcome. Further large study is warranted to clarify the optimal strategy, procedural details and clinical outcomes in the future.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
DOIs
StateAccepted/In press - 2017

Keywords

  • Mitraclip
  • Transcatheter aortic valve replacement
  • Transcatheter mitral valve repair
  • Valve-in-valve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Ando, T., Takagi, H., Briasoulis, A., Telila, T., Slovut, D. P., Afonso, L., Grines, C. L., & Schreiber, T. (Accepted/In press). A systematic review of reported cases of combined transcatheter aortic and mitral valve interventions. Catheterization and Cardiovascular Interventions. https://doi.org/10.1002/ccd.27256