Transcatheter Mitral Valve Replacement Using Annular Reduction by Cinching With TEER in the Commissure (ARCTIC)

• DOI: 10.1161/circinterventions.124.014224
• Publication Date: 2024-11-06T10:00:59Z
• Authors: Gregory J. Condos; David Elison; Logan L. Vincent; Rafael Harari; Cristina Sanina; Srdjan Jelacic; Richard Sheu; Christine J. Chung; Gabriel S. Aldea; G. Burkhard Macke...; James M. McCabe
• Keywords: Mitral valve replacement; Valve replacement; MitraClip

BACKGROUND: Mitral annular calcification with valve dysfunction remains a challenging syndrome. Operative risk is high, and available transcatheter therapies are limited. METHODS: This study describes our initial experience novel procedure to address large mitral annuli when no surgical or trial-based replacement device available. The rationale was shorten the intercommissural distance using commissural edge-to-edge repair (TEER) followed by valve-in-mitral balloon-expandable aortic platform. Patients long distances annulus areas were selected based on high perceived of embolization. underwent TEER MitraClip in position, immediately transseptal 29 mm SAPIEN 3 valve. RESULTS: Thirteen patients included. Median area 39.1 930 2 , respectively. Commissural successful all instances single leaflet detachment. In 10 13 instances, an NTW size used. 12 patients, implantation successful, including 1 case that required second for atrial positioning first case, frank embolization into left atrium occurred. Among cases, paravalvular leak 1+ less, there adjacent device. CONCLUSIONS: sufficient calcium, hybrid platform can be successfully used facilitate replacement.