Author + information
- Received August 30, 2017
- Revision received November 4, 2017
- Accepted December 12, 2017
- Published online March 19, 2018.
- Matteo Pagnesi, MDa,
- Damiano Regazzoli, MDa,
- Marco B. Ancona, MDa,
- Antonio Mangieri, MDa,
- Giuseppe Lanzillo, MDa,
- Francesco Giannini, MDa,b,
- Nicola Buzzatti, MDc,
- Bernard D. Prendergast, MDd,
- Susheel Kodali, MDe,
- Alexandra J. Lansky, MDf,g,
- Antonio Colombo, MDa,b,h and
- Azeem Latib, MDa,b,∗ ()
- aInterventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
- bInterventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy
- cDepartment of Cardiovascular and Thoracic Surgery, San Raffaele Scientific Institute, Milan, Italy
- dDepartment of Cardiology, St Thomas' Hospital, London, United Kingdom
- eDivision of Cardiology, Columbia University Medical Center, New York, New York
- fDivision of Cardiovascular Medicine and Yale Cardiovascular Research Group, Yale University School of Medicine, New Haven, Connecticut
- gDepartment of Cardiology, St Bartholomew's Hospital and William Harvey Research Institute and Queen Mary University of London, London, United Kingdom
- hVita-Salute San Raffaele University, Milan, Italy
- ↵∗Address for correspondence:
Dr. Azeem Latib, Interventional Cardiology Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
As new transcatheter mitral valve (MV) interventions continuously evolve, potential procedure-related adverse events demand careful investigation. The risk of cerebral embolic damage is ubiquitous in any left-sided structural heart intervention (and potentially linked to long-term neurocognitive sequelae); therefore, efforts to evaluate these aspects in the field of catheter-based MV procedures are justified. Given the peculiarities of MV anatomy, MV disease, and MV procedures, the lessons learned from other transcatheter heart interventions (i.e., transcatheter aortic valve replacement) cannot be directly translated to MV applications. Through a systematic assessment of available evidence, the authors present and discuss procedure- and patient-related factors potentially associated with cerebral embolic risk during catheter-based MV interventions. Given the paucity of available data in this field, future large, dedicated studies are needed to understand whether cerebral embolic injury represents a real clinical issue during MV procedures.
Dr. Prendergast has received research funding from Edwards Lifesciences; and speaker fees from Edwards Lifesciences, Boston Scientific, MVRx, and Symetis. Dr. Kodali has served as a consultant for Medtronic, Claret Medical, and Edwards Lifesciences; is the principal investigator of the SENTINEL trial, sponsored by Claret Medical; has served on the advisory boards of Thubrikar Aortic Valve and Dura Biotech; has received research support and travel reimbursement from Edwards Lifesciences, Claret Medical, and Medtronic; and holds equity in Thubrikar Aortic Valve (minimal) and Dura Biotech. Prof. Lansky has received research support from Keystone Heart, NeuroSave Inc., and Boston Scientific; and has received speaker/consultant fees from Keystone Heart. Dr. Latib has served on the advisory boards of Medtronic and Millipede; has received honoraria from Abbott Vascular; and has served as a consultant for Medtronic, Millipede, Valtech Cardio, MitralTech, Innovative Cardiovascular Solutions, Keystone Medical, and Mitralign. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 30, 2017.
- Revision received November 4, 2017.
- Accepted December 12, 2017.
- 2018 American College of Cardiology Foundation