New ESC Guidelines for TAVI and transcatheter mitral valve …Alec Vahanian University Paris...
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New ESC Guidelines for TAVI and transcatheter mitral valve repair Alec Vahanian University Paris VII,Paris ,France
New ESC Guidelines for TAVI and transcatheter mitral valve …Alec Vahanian University Paris VII,Paris ,France Recommandations in the ACC/AHA 2017 Update Mitral regurgitation Recommendations
New ESC Guidelines for TAVI and transcatheter mitral valve
repair
Alec Vahanian
University Paris VII,Paris ,France
Recommandations in the ACC/AHA 2017 Update
Mitral regurgitation
Recommendations in the ACC/AHA 2017 Update
2017 ESC/EACTS Guidelines for the Management of Valvular Heart
Disease (European Heart Journal 2017 -
doi:10.1093/eurheartj/ehx391)
)
www.escardio.org/guidelines 29
Recommendations Class Level
When revascularization is not indicated and surgical risk is not
low, a percutaneous edge-to-edge procedure may be considered in
patients with severe secondary mitral regurgitation and LVEF
>30% who remain symptomatic despite optimal medical management
(including CRT if indicated) and who have a suitable valve
morphology by echocardiography, avoiding futility.
IIb C
In patients with severe secondary mitral regurgitation and
LVEF
Recommendations in ACC/AHA Valve Guidelines Update 2017
“Percutaneous mitral valve repair provides a less
invasive alternative to surgery but is not approved for
clinical use for this indication in the United States .
The results of RCTs examining the efficacy of
percutaneous mitral valve repair in patients with
secondary MR are needed to provide information on
this patient group”
Conclusions
The update of the ACC/AHA and the new ESC/EACTS Guidelines are
consistent overall in recommending to enlarge the use of TAVI to
intermediate risk patients after an evaluation by the “Heart team”
based on an individualized approach
The ESC Guidelines state that Mitra clip may be considered in
selected high risk patients with primary or secondary MR while the
ACC/AHA Guidelines limit the use of the device to primary MR
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