Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspective
Objective: Electrosurgical laceration and stabilization of mitral clips (ELASTA-CLIP) is a bail-out technique to recreate a single-orifice mitral valve after transcatheter edge-to-edge repair (TEER) with subsequent transcatheter mitral valve replacement (TMVR). This technique is a novel option for p...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-12-01
|
| Series: | JTCVS Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250723002766 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849405275908341760 |
|---|---|
| author | Joerg Kellermair, MD Ilinca Damian, MD Michael Grund, MD Georg Hagleitner, MD Florian Huber, MD Michael Resl, MD Gregor Sulzbacher, MD Martin Clodi, MD Clemens Steinwender, MD Andreas Zierer, MD |
| author_facet | Joerg Kellermair, MD Ilinca Damian, MD Michael Grund, MD Georg Hagleitner, MD Florian Huber, MD Michael Resl, MD Gregor Sulzbacher, MD Martin Clodi, MD Clemens Steinwender, MD Andreas Zierer, MD |
| author_sort | Joerg Kellermair, MD |
| collection | DOAJ |
| description | Objective: Electrosurgical laceration and stabilization of mitral clips (ELASTA-CLIP) is a bail-out technique to recreate a single-orifice mitral valve after transcatheter edge-to-edge repair (TEER) with subsequent transcatheter mitral valve replacement (TMVR). This technique is a novel option for patients with significant residual mitral regurgitation after TEER with high risk for conventional surgery. The original ELASTA CLIP procedure features a transseptal approach, whereas the TMVR with the Tendyne bioprosthesis has a transapical access. Hereby we tested the hypothesis that a modified transapical ELASTA CLIP technique can be safely applied transapically allowing a straightforward one-stop shop access strategy. Methods: We developed the procedural steps in a porcine passive-beating heart model and applied the modified technique with subsequent TMVR in 2 consecutive patients with severe mitral regurgitation after previous TEER. Patients were followed up to 30 days. Results: The modified transapical ELASTA CLIP procedure was successful in both patients. The mean total procedure time was 118 minutes, and the mean fluoroscopy duration 22 minutes. At 30 days’ follow-up, both patients were alive without bleeding complications, reintervention, or prosthetic valve dysfunction. Conclusions: The modified transapical ELASTA CLIP procedure is technically feasible and safe at 30 days. Procedure times are lower compared with previous reports of the original transseptal approach. |
| format | Article |
| id | doaj-art-b05584d48e2e41a78b4143ddfb124470 |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-b05584d48e2e41a78b4143ddfb1244702025-08-20T03:36:42ZengElsevierJTCVS Techniques2666-25072023-12-012218919610.1016/j.xjtc.2023.07.028Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspectiveJoerg Kellermair, MD0Ilinca Damian, MD1Michael Grund, MD2Georg Hagleitner, MD3Florian Huber, MD4Michael Resl, MD5Gregor Sulzbacher, MD6Martin Clodi, MD7Clemens Steinwender, MD8Andreas Zierer, MD9Department of Cardiology and Internal Intensive Care Medicine, Kepler University Hospital Linz, Linz, Austria; Institute for Cardiovascular and Metabolic Research (ICMR), Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria; Address for reprints: Joerg Kellermair, MD, Department of Cardiology and Internal Intensive Care Medicine, Kepler University Hospital Linz, Krankenhausstrasse 9A, 4020 Linz, Austria.Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital Linz, Linz, AustriaDepartment of Cardiology and Internal Intensive Care Medicine, Kepler University Hospital Linz, Linz, AustriaCentral Radiology Institute, Kepler University Hospital Linz, Linz, AustriaInstitute for Cardiovascular and Metabolic Research (ICMR), Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria; Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital Linz, Linz, AustriaInstitute for Cardiovascular and Metabolic Research (ICMR), Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria; Department of Medicine, St John of God Hospital Linz, Linz, AustriaDepartment of Cardiothoracic and Vascular Surgery, Kepler University Hospital Linz, Linz, AustriaInstitute for Cardiovascular and Metabolic Research (ICMR), Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria; Department of Medicine, St John of God Hospital Linz, Linz, AustriaDepartment of Cardiology and Internal Intensive Care Medicine, Kepler University Hospital Linz, Linz, Austria; Institute for Cardiovascular and Metabolic Research (ICMR), Faculty of Medicine, Johannes Kepler University Linz, Linz, AustriaInstitute for Cardiovascular and Metabolic Research (ICMR), Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria; Department of Cardiothoracic and Vascular Surgery, Kepler University Hospital Linz, Linz, AustriaObjective: Electrosurgical laceration and stabilization of mitral clips (ELASTA-CLIP) is a bail-out technique to recreate a single-orifice mitral valve after transcatheter edge-to-edge repair (TEER) with subsequent transcatheter mitral valve replacement (TMVR). This technique is a novel option for patients with significant residual mitral regurgitation after TEER with high risk for conventional surgery. The original ELASTA CLIP procedure features a transseptal approach, whereas the TMVR with the Tendyne bioprosthesis has a transapical access. Hereby we tested the hypothesis that a modified transapical ELASTA CLIP technique can be safely applied transapically allowing a straightforward one-stop shop access strategy. Methods: We developed the procedural steps in a porcine passive-beating heart model and applied the modified technique with subsequent TMVR in 2 consecutive patients with severe mitral regurgitation after previous TEER. Patients were followed up to 30 days. Results: The modified transapical ELASTA CLIP procedure was successful in both patients. The mean total procedure time was 118 minutes, and the mean fluoroscopy duration 22 minutes. At 30 days’ follow-up, both patients were alive without bleeding complications, reintervention, or prosthetic valve dysfunction. Conclusions: The modified transapical ELASTA CLIP procedure is technically feasible and safe at 30 days. Procedure times are lower compared with previous reports of the original transseptal approach.http://www.sciencedirect.com/science/article/pii/S2666250723002766ELASTA-CLIPTendyneTMVRtransapicalelectrosurgery |
| spellingShingle | Joerg Kellermair, MD Ilinca Damian, MD Michael Grund, MD Georg Hagleitner, MD Florian Huber, MD Michael Resl, MD Gregor Sulzbacher, MD Martin Clodi, MD Clemens Steinwender, MD Andreas Zierer, MD Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspective JTCVS Techniques ELASTA-CLIP Tendyne TMVR transapical electrosurgery |
| title | Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspective |
| title_full | Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspective |
| title_fullStr | Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspective |
| title_full_unstemmed | Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspective |
| title_short | Transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement—A one-stop shopCentral MessagePerspective |
| title_sort | transapical electrosurgical laceration and stabilization of mitral clips followed by transcatheter mitral valve replacement a one stop shopcentral messageperspective |
| topic | ELASTA-CLIP Tendyne TMVR transapical electrosurgery |
| url | http://www.sciencedirect.com/science/article/pii/S2666250723002766 |
| work_keys_str_mv | AT joergkellermairmd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT ilincadamianmd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT michaelgrundmd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT georghagleitnermd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT florianhubermd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT michaelreslmd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT gregorsulzbachermd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT martinclodimd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT clemenssteinwendermd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective AT andreaszierermd transapicalelectrosurgicallacerationandstabilizationofmitralclipsfollowedbytranscathetermitralvalvereplacementaonestopshopcentralmessageperspective |