Author + information
- Received February 24, 2020
- Revision received May 28, 2020
- Accepted June 2, 2020
- Published online September 7, 2020.
- Miho Fukui, MD, PhDa,b,
- Paul Sorajja, MDb,
- Mario Gössl, MD, PhDb,
- Richard Bae, MDb,
- John R. Lesser, MDb,
- Benjamin Sun, MDc,
- Alison Duncan, MDd,
- David Muller, MDe and
- João L. Cavalcante, MDa,b,∗ (, )@JoaoLCavalcante
- aCardiovascular Imaging Research Center and Core Lab, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
- bValve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota
- cMinneapolis Heart Institute, Minneapolis, Minnesota
- dThe Royal Brompton Hospital, London, United Kingdom
- eSt. Vincent’s Hospital Sydney, Darlinghurst, Australia
- ↵∗Address for correspondence:
Dr. João L. Cavalcante, Cardiovascular Imaging Center and Core Lab, Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 100, Minneapolis, Minnesota 55407.
Objectives The aim of this study was to describe the anatomic and functional changes in left-sided chambers using computed tomographic angiography (CTA) from baseline to 1 month after transcatheter mitral valve replacement (TMVR) with the Tendyne prosthesis.
Background Data on changes in left atrial and left ventricular (LV) volumes after TMVR implantation are very limited.
Methods Patients who underwent TMVR with the Tendyne prosthesis between 2015 and 2018 were analyzed. Changes in LV end-diastolic volume, ejection fraction, LV mass, left atrial volume, and global longitudinal strain were assessed at baseline and 1 month after TMVR using CTA. Specific Tendyne implant characteristics were identified and correlated with remodeling changes.
Results A total of 36 patients (median age 74 years; interquartile range [IQR]: 69 to 78 years; 78% men; 86% with secondary mitral regurgitation) were included in this study. There were significant decreases in LV end-diastolic volume (281 ml [IQR: 210 to 317 ml] vs. 239 ml [IQR: 195 to 291 ml]; p < 0.001), LV ejection fraction (37% [IQR: 31% to 48%] vs. 30% [IQR: 23% to 40%]; p < 0.001), LV mass (126 g [IQR: 96 to 155 g] vs. 116 g [IQR: 92 to 140 g]; p < 0.001), left atrial volume (171 ml [IQR: 133 to 216 ml] vs. 159 ml [IQR: 125 to 201 ml]; p = 0.027), and global longitudinal strain (−11% [IQR: −17% to −8%] vs. −9% [IQR: −12% to −6%]; p < 0.001) from baseline to 1-month follow-up. Favorable LV end-diastolic volume reverse remodeling occurred in the majority (30 of 36 patients [83%]). Closer proximity of the Tendyne apical pad to the true apex (24 mm [IQR: 21 to 29 mm] vs. 35 mm [IQR: 26 to 40 mm]) was predictive of favorable remodeling (p = 0.037).
Conclusions TMVR with Tendyne results in favorable left-sided chamber remodeling in the majority of patients treated, as detected on CTA at 1 month after implantation. CTA identifies favorable post-TMVR changes, which could be related to specific characteristics of the device implantation.
- computed tomographic angiography
- mitral regurgitation
- reserve remodeling
- transcatheter mitral valve replacement
Drs. Sorajja, Muller, and Cavalcante have received research grant support from Abbott Vascular. Drs. Sorajja, Sun, Duncan, Muller, and Cavalcante have received consulting fees from Abbott Vascular. Drs. Sorajja and Bae are members of the Abbott Vascular Speakers Bureau. Drs. Sun, Duncan, and Muller are proctors for Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Cardiovascular Interventions author instructions page.
- Received February 24, 2020.
- Revision received May 28, 2020.
- Accepted June 2, 2020.
- 2020 American College of Cardiology Foundation
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