Percutaneous coronary intervention before NeoChord mitral valve repair: Expanding the spectrum of hybrid procedures

2021 ◽  
Author(s):  
Cesar E. Mendoza
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Coronary Intervention ◽  
Valve Repair ◽  
Hybrid Procedures ◽  
Percutaneous Coronary

Simultaneous Robotic-Assisted Mitral Valve Repair and Percutaneous Coronary Intervention

2010 ◽  
Vol 5 (5) ◽  
pp. 375-377 ◽  
Author(s):  
Corey Adams ◽  
R. Scott McClure ◽  
Aashish Goela ◽  
Daniel Bainbridge ◽  
William J. Kostuk ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Case Report ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Coronary Intervention ◽  
Valve Repair ◽  
Operating Theater ◽  
Robotic Assisted ◽  
Percutaneous Coronary ◽  
The Right

We present a case report of a robotic-assisted mitral valve repair with simultaneous percutaneous coronary intervention. A 58-year-old man presented with New York Heart Association class III symptoms from severe mitral regurgitation and significant stenosis of the right coronary artery. In a hybrid operating theater, the patient underwent placement of a bare metal stent in the right coronary artery followed immediately by robotic-assisted mitral valve repair. Both procedures were successful and occurred in a timely fashion. The patient experienced no immediate postoperative complications and was discharged home on postoperative day 5. At 2-week follow-up, he had returned to his normal activities of daily living and at 1 year remained asymptomatic. This case report demonstrates the benefits of minimally invasive robotic mitral valve repair in allowing for successful repair, early postoperative return to activity, minimal incision pain, and high patient satisfaction. It further highlights the potential benefit of a hybrid operating theater in allowing surgical and percutaneous coronary intervention procedures to be delivered in a safe and efficient manner.

scholarly journals Longitudinal Evaluation of Mitral Valve Leaflet Remodeling After Acute Myocardial Infarction

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Shun Nishino ◽  
Nozomi Watanabe ◽  
Toshihiro Gi ◽  
Nehiro Kuriyama ◽  
Yoshisato Shibata ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Mitral Valve ◽  
Primary Percutaneous Coronary Intervention ◽  
Complex Geometry ◽  
Coronary Intervention ◽  
Mitral Valve Leaflet ◽  
Percutaneous Coronary

Background: Recent animal studies have suggested that mitral valve (MV) leaflet remodeling can occur even without significant tethering force and that the postinfarct biological reaction would contribute to the histopathologic changes of the leaflet. We serially evaluated the MV remodeling in patients with anterior and inferior acute myocardial infarction (MI), by using 2- and 3-dimensional transthoracic echocardiography. Additional histopathologic examinations were performed to assess the leaflet pathology. Methods: Sixty consecutive first-onset acute MI (anterior MI, n=30; inferior MI, n=30) patients who underwent successful primary percutaneous coronary intervention were examined (1) before primary percutaneous coronary intervention, (2) at 6-month follow-up, and (3) at follow-up 1 year or later after onset. MV complex geometry including MV leaflet area and thickness was analyzed using dedicated software. Additional histopathologic study compared 18 valves harvested during surgery for ischemic mitral regurgitation (MR). Results: MV area and thickness incrementally increased during the follow-up period. MV leaflet area significantly increased (anterior MI: 5.59 [5.28–5.98] to 6.54 [6.20–7.26] cm 2 /m 2 , P <0.001; inferior MI: 5.60 [4.76–6.08] to 6.32 [5.90–6.90] cm 2 /m 2 , P <0.001), and leaflet thickness also increased (anterior MI: 1.09 [0.92–1.24] to 1.45 [1.28–1.60] mm/m 2 , P <0.001; inferior MI: 1.15 [1.03–1.25] to 1.44 [1.27–1.59] mm/m 2 , P <0.001); data represent onset versus ≥1 year. Larger annuls, larger tenting, and a reduced leaflet area/annular ratio with smaller coaptation index were observed in patients with persistent ischemic MR compared with those without significant ischemic MR. Histopathologic examinations revealed that MV thickness was significantly greater in chronic ischemic MR compared with acute ischemic MR (1432.6±490.5 versus 628.7±278.7 μm; P =0.001), with increased smooth muscle cells and fibrotic materials. Conclusions: MV leaflet remodeling progressed both in area and thickness after MI. This is the first clinical study to record the longitudinal course of MV leaflet remodeling by serial echocardiography.

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