Current state of the art in transcatheter mitral valve replacement_West China Medical Journal

Authors：

JIN Zhiyuan ,  WANG Bin

Department of Emergency, the Xiamen Cardiovascular Hospital of Xiamen University, Xiamen, Fujian 361000, P. R. China;

Corresponding author：

WANG Bin, Email: mocw361@163.com

Keywords：

Transcatheter mitral valve replacement; mitral regurgitation; research update

DOI：

10.7507/1002-0179.202408257

Video：

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Mitral regurgitation (MR) is one of the most common valvular heart diseases, imposing a significant economic burden on society. Transcatheter mitral valve replacement (TMVR), as an emerging therapeutic strategy for MR, is expected to fill the gap in the treatment of transcatheter edge-to-edge repair in the future. This article reviews the progress of TMVR clinical research both domestically and internationally in the past two years and analyzes the current challenges faced by TMVR research, such as mitral valve anatomy, device access transition, valve design, and mitral valve calcification. Finally, the prospects of mitral valve product research are discussed.

1.	Dziadzko V, Clavel MA, Dziadzko M, et al. Outcome and undertreatment of mitral regurgitation: a community cohort study. Lancet, 2018, 391(10124): 960-969.
2.	Coffey S, Roberts-Thomson R, Brown A, et al. Global epidemiology of valvular heart disease. Nat Rev Cardiol, 2021, 18(12): 853-864.
3.	Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): 450-500.
4.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
5.	Coisne A, Lancellotti P, Habib G, et al. ACC/AHA and ESC/EACTS guidelines for the management of valvular heart diseases: JACC guideline comparison. J Am Coll Cardiol, 2023, 82(8): 721-734.
6.	Kataoka A, Watanabe Y, OCEAN-SHD Family. MitraClip: a review of its current status and future perspectives. Cardiovasc Interv Ther, 2023, 38(1): 28-38.
7.	Puls M, Lubos E, Boekstegers P, et al. One-year outcomes and predictors of mortality after MitraClip therapy in contemporary clinical practice: results from the German transcatheter mitral valve interventions registry. Eur Heart J, 2016, 37(8): 703-712.
8.	Sorajja P, Vemulapalli S, Feldman T, et al. Outcomes with transcatheter mitral valve repair in the United States: an STS/ACC TVT registry report. J Am Coll Cardiol, 2017, 70(19): 2315-2327.
9.	Glower DD, Kar S, Trento A, et al. Percutaneous mitral valve repair for mitral regurgitation in high-risk patients: results of the EVEREST II study. J Am Coll Cardiol, 2014, 64(2): 172-181.
10.	Meier D, Akodad M, Tzimas G, et al. Update on transcatheter treatment of mitral and tricuspid valve regurgitation. Curr Cardiol Rep, 2023, 25(10): 1361-1371.
11.	Ben Ali W, Ludwig S, Duncan A, et al. Characteristics and outcomes of patients screened for transcatheter mitral valve implantation: 1-year results from the CHOICE-MI registry. Eur J Heart Fail, 2022, 24(5): 887-898.
12.	Alperi A, Granada JF, Bernier M, et al. Current status and future prospects of transcatheter mitral valve replacement: JACC State-of-the-Art Review. J Am Coll Cardiol, 2021, 77(24): 3058-3078.
13.	Sorajja P, Moat N, Badhwar V, et al. Initial feasibility study of a new transcatheter mitral prosthesis: the first 100 patients. J Am Coll Cardiol, 2019, 73(11): 1250-1260.
14.	Wild MG, Kreidel F, Hell MM, et al. Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience. Eur J Heart Fail, 2022, 24(5): 899-907.
15.	Muller DWM, Sorajja P, Duncan A, et al. 2-year outcomes of transcatheter mitral valve replacement in patients with severe symptomatic mitral regurgitation. J Am Coll Cardiol, 2021, 78(19): 1847-1859.
16.	Wilde N, Tanaka T, Vij V, et al. Characteristics and outcomes of patients undergoing transcatheter mitral valve replacement with the Tendyne system. Clin Res Cardiol, 2024, 113(1): 1-10.
17.	Bapat V, Rajagopal V, Meduri C, et al. Early experience with new transcatheter mitral valve replacement. J Am Coll Cardiol, 2018, 71(1): 12-21.
18.	Luo Z, Zhang H, Xie Y, et al. Clinical application of a fully ultrasound-guided transapical transcatheter mitral valve replacement device. JACC Cardiovasc Interv, 2020, 13(17): e161-e162.
19.	Yang Y, Chen J, Dong L, et al. Transcatheter mitral valve replacement with Mi-thos system: first-in-human experience. Catheter Cardiovasc Interv, 2024, 103(1): 153-159.
20.	Tang JY, Liu Y, Yang J. A novel case of transcatheter mitral valve-in-valve replacement using Mi-thos™ system. J Geriatr Cardiol, 2020, 17(4): 229-233.
21.	Ninios V, Ninios I, Ranard LS, et al. Transcatheter transseptal treatment of patients with severe mitral regurgitation using an atrial fixation mitral valve replacement technology. Cardiovasc Revasc Med, 2024, 58: 25-30.
22.	Coisne A, Pontana F, Tchétché D, et al. Transcatheter mitral valve replacement: factors associated with screening success and failure. EuroIntervention, 2019, 15(11): e983-e989.
23.	Eleid MF, Collins JD, Mahoney P, et al. Emerging approaches to management of left ventricular outflow obstruction risk in transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2023, 16(8): 885-895.
24.	Marom G, Plitman Mayo R, Again N, et al. Numerical biomechanics models of the interaction between a novel transcatheter mitral valve device and the subvalvular apparatus. Innovations (Phila), 2021, 16(4): 327-333.
25.	Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet, 1995, 346(8969): 211-214.
26.	Babaliaros VC, Greenbaum AB, Khan JM, et al. Intentional percutaneous laceration of the anterior mitral leaflet to prevent outflow obstruction during transcatheter mitral valve replacement: first in-human experience. J Am Coll Cardiol Intv, 2017, 10(8): 798-809.
27.	Preston-Maher GL, Torii R, Burriesci G. A technical review of minimally invasive mitral valve replacements. Cardiovasc Eng Technol, 2015, 6(2): 174-184.
28.	Ribeiro HB, Nombela-Franco L, Muñoz-García AJ, et al. Predictors and impact of myocardial injury after transcatheter aortic valve replacement: a multicenter registry. J Am Coll Cardiol, 2015, 66(19): 2075-2088.
29.	潘文志, 周达新, 葛均波. 经导管二尖瓣置换术的应用现状与展望. 上海医药, 2017, 38(3): 11-15.
30.	Tiwana J, Aldea G, Levin DB, et al. Contemporary transcatheter mitral valve replacement for mitral annular calcification or ring. JACC Cardiovasc Interv, 2020, 13(20): 2388-2398.
31.	Eleid MF, Whisenant BK, Cabalka AK, et al. Early outcomes of percutaneous transvenous transseptal transcatheter valve implantation in failed bioprosthetic mitral valves, ring annuloplasty, and severe mitral annular calcification. JACC Cardiovasc Interv, 2017, 10(19): 1932-1942.
32.	Praz F, Khalique OK, Lee R, et al. Transatrial implantation of a transcatheter heart valve for severe mitral annular calcification. J Thorac Cardiovasc Surg, 2018, 156(1): 132-142.
33.	Guerrero M, Urena M, Himbert D, et al. 1-year outcomes of transcatheter mitral valve replacement in patients with severe mitral annular calcification. J Am Coll Cardiol, 2018, 71(17): 1841-1853.
34.	Yoon SH, Whisenant BK, Bleiziffer S, et al. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J, 2019, 40(5): 441-451.
35.	Guerrero M, Vemulapalli S, Xiang Q, et al. Thirty-day outcomes of transcatheter mitral valve replacement for degenerated mitral bioprostheses (valve-in-valve), failed surgical rings (valve-in-ring), and native valve with severe mitral annular calcification (valve-in-mitral annular calcification) in the United States: data from the Society of Thoracic Surgeons/American College of Cardiology/Transcatheter Valve Therapy Registry. Circ Cardiovasc Interv, 2020, 13(3): e008425.
36.	Guerrero M, Wang DD, Eleid MF, et al. Prospective study of TMVR using balloon-expandable aortic transcatheter valves in MAC: MITRAL trial 1-year outcomes. JACC Cardiovasc Interv, 2021, 14(8): 830-845.
37.	Urena M, Lemann T, Chong-Nguyen C, et al. Causes and predictors of mortality after transcatheter mitral valve implantation in patients with severe mitral annulus calcification. Catheter Cardiovasc Interv, 2021, 98(5): 981-989.
38.	Ribeiro RVP, Yanagawa B, Légaré JF, et al. Clinical outcomes of mitral valve intervention in patients with mitral annular calcification: a systematic review and meta-analysis. J Card Surg, 2020, 35(1): 66-74.

1. Dziadzko V, Clavel MA, Dziadzko M, et al. Outcome and undertreatment of mitral regurgitation: a community cohort study. Lancet, 2018, 391(10124): 960-969.
2. Coffey S, Roberts-Thomson R, Brown A, et al. Global epidemiology of valvular heart disease. Nat Rev Cardiol, 2021, 18(12): 853-864.
3. Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): 450-500.
4. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
5. Coisne A, Lancellotti P, Habib G, et al. ACC/AHA and ESC/EACTS guidelines for the management of valvular heart diseases: JACC guideline comparison. J Am Coll Cardiol, 2023, 82(8): 721-734.
6. Kataoka A, Watanabe Y, OCEAN-SHD Family. MitraClip: a review of its current status and future perspectives. Cardiovasc Interv Ther, 2023, 38(1): 28-38.
7. Puls M, Lubos E, Boekstegers P, et al. One-year outcomes and predictors of mortality after MitraClip therapy in contemporary clinical practice: results from the German transcatheter mitral valve interventions registry. Eur Heart J, 2016, 37(8): 703-712.
8. Sorajja P, Vemulapalli S, Feldman T, et al. Outcomes with transcatheter mitral valve repair in the United States: an STS/ACC TVT registry report. J Am Coll Cardiol, 2017, 70(19): 2315-2327.
9. Glower DD, Kar S, Trento A, et al. Percutaneous mitral valve repair for mitral regurgitation in high-risk patients: results of the EVEREST II study. J Am Coll Cardiol, 2014, 64(2): 172-181.
10. Meier D, Akodad M, Tzimas G, et al. Update on transcatheter treatment of mitral and tricuspid valve regurgitation. Curr Cardiol Rep, 2023, 25(10): 1361-1371.
11. Ben Ali W, Ludwig S, Duncan A, et al. Characteristics and outcomes of patients screened for transcatheter mitral valve implantation: 1-year results from the CHOICE-MI registry. Eur J Heart Fail, 2022, 24(5): 887-898.
12. Alperi A, Granada JF, Bernier M, et al. Current status and future prospects of transcatheter mitral valve replacement: JACC State-of-the-Art Review. J Am Coll Cardiol, 2021, 77(24): 3058-3078.
13. Sorajja P, Moat N, Badhwar V, et al. Initial feasibility study of a new transcatheter mitral prosthesis: the first 100 patients. J Am Coll Cardiol, 2019, 73(11): 1250-1260.
14. Wild MG, Kreidel F, Hell MM, et al. Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience. Eur J Heart Fail, 2022, 24(5): 899-907.
15. Muller DWM, Sorajja P, Duncan A, et al. 2-year outcomes of transcatheter mitral valve replacement in patients with severe symptomatic mitral regurgitation. J Am Coll Cardiol, 2021, 78(19): 1847-1859.
16. Wilde N, Tanaka T, Vij V, et al. Characteristics and outcomes of patients undergoing transcatheter mitral valve replacement with the Tendyne system. Clin Res Cardiol, 2024, 113(1): 1-10.
17. Bapat V, Rajagopal V, Meduri C, et al. Early experience with new transcatheter mitral valve replacement. J Am Coll Cardiol, 2018, 71(1): 12-21.
18. Luo Z, Zhang H, Xie Y, et al. Clinical application of a fully ultrasound-guided transapical transcatheter mitral valve replacement device. JACC Cardiovasc Interv, 2020, 13(17): e161-e162.
19. Yang Y, Chen J, Dong L, et al. Transcatheter mitral valve replacement with Mi-thos system: first-in-human experience. Catheter Cardiovasc Interv, 2024, 103(1): 153-159.
20. Tang JY, Liu Y, Yang J. A novel case of transcatheter mitral valve-in-valve replacement using Mi-thos™ system. J Geriatr Cardiol, 2020, 17(4): 229-233.
21. Ninios V, Ninios I, Ranard LS, et al. Transcatheter transseptal treatment of patients with severe mitral regurgitation using an atrial fixation mitral valve replacement technology. Cardiovasc Revasc Med, 2024, 58: 25-30.
22. Coisne A, Pontana F, Tchétché D, et al. Transcatheter mitral valve replacement: factors associated with screening success and failure. EuroIntervention, 2019, 15(11): e983-e989.
23. Eleid MF, Collins JD, Mahoney P, et al. Emerging approaches to management of left ventricular outflow obstruction risk in transcatheter mitral valve replacement. JACC Cardiovasc Interv, 2023, 16(8): 885-895.
24. Marom G, Plitman Mayo R, Again N, et al. Numerical biomechanics models of the interaction between a novel transcatheter mitral valve device and the subvalvular apparatus. Innovations (Phila), 2021, 16(4): 327-333.
25. Sigwart U. Non-surgical myocardial reduction for hypertrophic obstructive cardiomyopathy. Lancet, 1995, 346(8969): 211-214.
26. Babaliaros VC, Greenbaum AB, Khan JM, et al. Intentional percutaneous laceration of the anterior mitral leaflet to prevent outflow obstruction during transcatheter mitral valve replacement: first in-human experience. J Am Coll Cardiol Intv, 2017, 10(8): 798-809.
27. Preston-Maher GL, Torii R, Burriesci G. A technical review of minimally invasive mitral valve replacements. Cardiovasc Eng Technol, 2015, 6(2): 174-184.
28. Ribeiro HB, Nombela-Franco L, Muñoz-García AJ, et al. Predictors and impact of myocardial injury after transcatheter aortic valve replacement: a multicenter registry. J Am Coll Cardiol, 2015, 66(19): 2075-2088.
29. 潘文志, 周达新, 葛均波. 经导管二尖瓣置换术的应用现状与展望. 上海医药, 2017, 38(3): 11-15.
30. Tiwana J, Aldea G, Levin DB, et al. Contemporary transcatheter mitral valve replacement for mitral annular calcification or ring. JACC Cardiovasc Interv, 2020, 13(20): 2388-2398.
31. Eleid MF, Whisenant BK, Cabalka AK, et al. Early outcomes of percutaneous transvenous transseptal transcatheter valve implantation in failed bioprosthetic mitral valves, ring annuloplasty, and severe mitral annular calcification. JACC Cardiovasc Interv, 2017, 10(19): 1932-1942.
32. Praz F, Khalique OK, Lee R, et al. Transatrial implantation of a transcatheter heart valve for severe mitral annular calcification. J Thorac Cardiovasc Surg, 2018, 156(1): 132-142.
33. Guerrero M, Urena M, Himbert D, et al. 1-year outcomes of transcatheter mitral valve replacement in patients with severe mitral annular calcification. J Am Coll Cardiol, 2018, 71(17): 1841-1853.
34. Yoon SH, Whisenant BK, Bleiziffer S, et al. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J, 2019, 40(5): 441-451.
35. Guerrero M, Vemulapalli S, Xiang Q, et al. Thirty-day outcomes of transcatheter mitral valve replacement for degenerated mitral bioprostheses (valve-in-valve), failed surgical rings (valve-in-ring), and native valve with severe mitral annular calcification (valve-in-mitral annular calcification) in the United States: data from the Society of Thoracic Surgeons/American College of Cardiology/Transcatheter Valve Therapy Registry. Circ Cardiovasc Interv, 2020, 13(3): e008425.
36. Guerrero M, Wang DD, Eleid MF, et al. Prospective study of TMVR using balloon-expandable aortic transcatheter valves in MAC: MITRAL trial 1-year outcomes. JACC Cardiovasc Interv, 2021, 14(8): 830-845.
37. Urena M, Lemann T, Chong-Nguyen C, et al. Causes and predictors of mortality after transcatheter mitral valve implantation in patients with severe mitral annulus calcification. Catheter Cardiovasc Interv, 2021, 98(5): 981-989.
38. Ribeiro RVP, Yanagawa B, Légaré JF, et al. Clinical outcomes of mitral valve intervention in patients with mitral annular calcification: a systematic review and meta-analysis. J Card Surg, 2020, 35(1): 66-74.

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