Considerations of Mitral and Tricuspid Transcatheter Therapies
Transcatheter mitral and tricuspid valve therapies continue to develop rapidly, with an increasing number of devices undergoing preclinical and clinical evaluation. In this issue, we have gathered experts from across these specialties to help synthesize information on recent trial outcomes and newly approved devices and indications for mitral and tricuspid valve therapies. We also feature discussions to help physicians better understand imaging and diagnostic techniques to better inform their patient treatment plans.
To kick off this issue’s coverage of mitral transcatheter therapies, Dr. Feldman; Paul Sorajja, MD; Paul Grayburn, MD; and Francesco Maisano, MD, review the use of transcatheter leaflet repair to treat functional mitral regurgitation and contemplate the possible impact of the data from randomized trials in this clinical space that will become available this year.
Shingo Kuwata, MD, and Francesco Maisano, MD, then offer an evaluation of the mitral annuloplasty device landscape by appraising the existing and upcoming devices for direct and indirect transcatheter annuloplasty procedures.
Degenerative mitral regurgitation remains a challenging clinical diagnosis to treat. Andrea Colli, MD, and colleagues review the use of transcatheter chordal repair and other therapeutic options to help treat patients with this condition.
Then, Nishtha Sodhi, MD, and Alan Zajarias, MD, take us on a tour of the emerging frontier of new technical, anatomic, and clinical challenges we face with transcatheter mitral valve replacement.
For our coverage of tricuspid therapies, Antonio Mangieri, MD; Giorgios Tzanis, MD; and Dr. Latib review the current state of transcatheter tricuspid valve therapies and discuss where the field is headed. Charles J. Davidson, MD, and colleagues then identify the essential needs of physicians using echocardiographic imaging for percutaneous tricuspid interventions.
Wrapping up our cover feature on mitral and tricuspid therapies, Philipp Lurz, MD, and Mehul B. Patel, MD, share the necessary details that physicians need to consider when expanding their practice to include a MitraClip and TriClip (Abbott Vascular) program.
Also in this issue, Lawrence Ong, MD, presents a case review on the use of patent foramen ovale closure for patients with cryptogenic stroke. Then, Salman Azhar, MD, and Jonathan M. Tobis, MD, discuss the appropriateness of this approach given the current guidelines and available evidence from trials.
Finally, in our featured interview, Marco Barbanti, MD, discusses the background of the FAST-TAVI study and MitraClip implantation and addresses coronary artery disease in patients undergoing transcatheter aortic valve implantation.
This issue should familiarize you with some of the innovative as well as established therapies in the field of valvular interventions. We hope these articles keep you updated on this rapidly growing field and help you understand the challenges and advantages of establishing a mitral and tricuspid program, recognize which patients to refer for these therapies, and appreciate the importance of a multidisciplinary team in ensuring excellent outcomes and that treating mitral and tricuspid disease will require a tailored approach utilizing a number of different devices.
Ted E. Feldman, MD, MSCAI, FACC, FESC
Chief Medical Editor
Azeem Latib, MD
Guest Chief Medical Editor