Transcatheter Structural Heart Interventions in the Acute Setting: An Emerging Indication

Structural heart disease is increasingly prevalent in the general population, especially in patients of increased age. Recent advances in transcatheter structural heart interventions have gained a significant following and are now considered a mainstay option for managing stable valvular disease. However, the concept of transcatheter interventions has also been tested in acute settings by several investigators, especially in cases where valvular disease comes as a result of acute ischemia or in the context of acute decompensated heart failure. Tested interventions include both the mitral and aortic valve, mostly evaluating mitral transcatheter edge-to-edge repair and transcatheter aortic valve implantation, respectively. This review is going to focus on the use of acute structural heart interventions in the emergent setting, and it will delineate the available data and provide a meaningful discussion on the optimal patient phenotype and future directions of the field.

[1]  C. Tsioufis,et al.  Mortality Rates in Patients Undergoing Urgent Versus Elective Transcatheter Aortic Valve Replacement: A Meta-analysis. , 2024, Angiology.

[2]  U. Kappert,et al.  Transcatheter or Surgical Treatment of Aortic-Valve Stenosis. , 2024, The New England journal of medicine.

[3]  C. Terkelsen,et al.  Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. , 2024, The New England journal of medicine.

[4]  O. Hamzaoui,et al.  Management of cardiogenic shock: a narrative review , 2024, Annals of intensive care.

[5]  M. Ambrosino,et al.  Tricuspid Regurgitation: A Review of Current Interventional Management , 2024, Journal of the American Heart Association.

[6]  F. Praz,et al.  Transcatheter treatment of the tricuspid valve: current status and perspectives. , 2024, European heart journal.

[7]  N. Ihlemann,et al.  Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial , 2024, European heart journal.

[8]  M. Taramasso,et al.  Transcatheter edge‐to‐edge repair in papillary muscle injury complicating acute myocardial infarction , 2024, ESC heart failure.

[9]  M. Shuvy,et al.  Evolving indications for transcatheter mitral edge-to-edge repair. , 2024, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[10]  Zaher Fanari,et al.  Urgent Transcatheter Mitral Valve-in-Valve Replacement With Venoarterial Extracorporeal Membrane Oxygenation Support: Case Report and Review of the Literature , 2024, Cureus.

[11]  D. Kolte,et al.  Transcatheter edge‐to‐edge mitral valve repair for mitral regurgitation in patients with cardiogenic shock: A systematic review and meta‐analysis , 2023, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[12]  S. Deseive,et al.  Concomitant percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation , 2023, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[13]  K. Aggeli,et al.  Intravascular Imaging in Ultra-Low or Zero-Contrast Percutaneous Coronary Interventions: The Time Is Now? , 2023, Journal of clinical medicine.

[14]  B. Alaour,et al.  Combined Significant Aortic Stenosis and Mitral Regurgitation: Challenges in Timing and Type of Intervention. , 2023, The Canadian journal of cardiology.

[15]  S. Jalil,et al.  Severe mitral stenosis masquerading as cardiogenic shock successfully managed with extracorporeal membrane oxygenation and percutaneous mitral commissurotomy: a case report , 2023, European heart journal. Case reports.

[16]  K. Aznaouridis,et al.  TCT-723 Urgent TEER in 5,428 Patients With Severe Mitral Regurgitation and Cardiogenic Shock: A Systematic Review and Meta-Analysis , 2023, Journal of the American College of Cardiology.

[17]  O. Aksoy,et al.  Trans-catheter mitral valve-in-valve replacement in a patient on venoarterial extracorporeal membrane oxygenation: a case report , 2023, European heart journal. Case reports.

[18]  J. Mehilli,et al.  Transcatheter interventions for left-sided valvular heart disease complicated by cardiogenic shock: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the Association for Acute Cardiovascular (ACVC) and the ESC Working Group , 2023, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[19]  R. Cruz Ferreira,et al.  Urgent versus Non-Urgent Transcatheter Aortic Valve Implantation Outcomes , 2023, Cardiology.

[20]  M. Ieda,et al.  Emergency transcatheter aortic valve implantation with a self-expandable valve under extracorporeal membrane oxygenation for cardiogenic shock due to bicuspid aortic stenosis: a case report , 2023, European heart journal. Case reports.

[21]  K. Goel,et al.  Outcomes of transcatheter aortic valve replacement in patients with cardiogenic shock , 2023, European heart journal.

[22]  R. Kornowski,et al.  Acute Reduction in Left Ventricular Function Following Transcatheter Mitral Edge‐to‐Edge Repair , 2023, Journal of the American Heart Association.

[23]  G. Filippatos,et al.  Acute heart failure and valvular heart disease: A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology , 2023, European journal of heart failure.

[24]  J. Escaned,et al.  Procedural and Technological Innovations Facilitating Ultra-low Contrast Percutaneous Coronary Interventions , 2023, Interventional cardiology.

[25]  D. Dvir,et al.  Urgent transcatheter edge-to-edge repair for severe mitral regurgitation with flail leaflet in critically Ill patients , 2023, medRxiv.

[26]  P. Villablanca,et al.  Application of Impella mechanical circulatory support devices in transcatheter aortic valve replacement and balloon aortic valvuloplasty: A single center experience. , 2023, Cardiovascular revascularization medicine : including molecular interventions.

[27]  D. Dudek,et al.  Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions in collaboration with the ESC Working Group on Cardiovascular Surgery. , 2023, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[28]  M. Alkhouli,et al.  Safety and Feasibility of Staged Versus Concomitant Transcatheter Edge-to-Edge Mitral Valve Repair After Transcatheter Aortic Valve Implantation. , 2023, The American journal of cardiology.

[29]  A. Shah,et al.  Stages of Valvular Heart Disease Among Older Adults in the Community: The Atherosclerosis Risk in Communities Study , 2022, Circulation.

[30]  M. Brankovic,et al.  Transcatheter Aortic Valve Replacement as a Rescue Treatment for Prosthetic Valve Endocarditis , 2022, JACC. Case reports.

[31]  Mariko Ozeki,et al.  Emergency Transcatheter Aortic Valve Implantation in a Surgical Aortic Bioprosthetic Valve for Acute Decompensated Heart Failure Caused by Sudden Progression of Structural Valve Deterioration , 2022, Internal medicine.

[32]  T. Imamura,et al.  Case series of transcatherter edge-to-edge repair using MitraClip™ system with Impella® mechanical circulatory support , 2022, European heart journal. Case reports.

[33]  P. Bertrand,et al.  Acute valvular emergencies. , 2022, European heart journal. Acute cardiovascular care.

[34]  S. Fernando,et al.  Transcatheter Mitral Valve Repair for Inotrope Dependent Cardiogenic Shock - Design and Rationale of the CAPITAL MINOS Trial. , 2022, American heart journal.

[35]  A. Edris,et al.  Transcatheter aortic valve replacement in a patient with critical bicuspid aortic stenosis and cardiogenic shock: case report , 2022, European heart journal. Case reports.

[36]  J. Kleijnen,et al.  Transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis: a systematic review and meta-analysis , 2021, BMJ Open.

[37]  N. Kleiman,et al.  Comparative Outcomes of Transcatheter Aortic Valve Implantation and Mitral Transcatheter Edge-to-Edge Repair: Same Versus Different Hospitalization. , 2021, The American journal of cardiology.

[38]  D. Dvir,et al.  Conservative, surgical, and percutaneous treatment for mitral regurgitation shortly after acute myocardial infarction. , 2021, European heart journal.

[39]  S. Kapadia,et al.  Combined Transcatheter Aortic and Mitral Valve Interventions: Insights From a National Database. , 2021, JACC. Cardiovascular interventions.

[40]  J. Prillinger,et al.  Survival Following Edge‐to‐Edge Transcatheter Mitral Valve Repair in Patients With Cardiogenic Shock: A Nationwide Analysis , 2021, Journal of the American Heart Association.

[41]  A. Colombo,et al.  Use of edge‐to‐edge percutaneous mitral valve repair for severe mitral regurgitation in cardiogenic shock: A multicenter observational experience (MITRA‐SHOCK study) , 2021, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[42]  Y. Agmon,et al.  Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry) , 2021, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[43]  S. Davies,et al.  Left Impella®-device as bridge from cardiogenic shock with acute, severe mitral regurgitation to MitraClip®-procedure: a new option for critically ill patients. , 2020, European heart journal. Acute cardiovascular care.

[44]  K. Kinugawa,et al.  A case report of advanced heart failure refractory to pharmacological therapy who was successfully recovered by combinatory usage of cardiac resynchronizing therapy, Impella and MitraClip , 2020, European heart journal. Case reports.

[45]  G. Tarantini,et al.  Transcatheter aortic valve implantation (TAVI) in cardiogenic shock: TAVI‐shock registry results , 2020, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[46]  A. Kosinski,et al.  Demographics, Procedural Characteristics, and Clinical Outcomes When Cardiogenic Shock Precedes TAVR in the United States. , 2020, JACC. Cardiovascular interventions.

[47]  N. Marchionni,et al.  Percutaneous left ventricular advanced support for ‘protected’ complex high-risk transcatheter mitral valve repair: a case series , 2020, European heart journal. Case reports.

[48]  N. Marx,et al.  Hemodynamic support with Impella ventricular assist device in patients undergoing TAVI: A single center experience , 2020, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[49]  R. Makkar,et al.  Timing and Outcomes of Percutaneous Coronary Intervention in Patients Who Underwent Transcatheter Aortic Valve Implantation. , 2020, The American journal of cardiology.

[50]  H. Heidbuchel,et al.  Afterload Mismatch After MitraClip Implantation: Intraoperative Assessment and Prognostic Implications. , 2020, The Journal of invasive cardiology.

[51]  J. Ali,et al.  Emergency valve‐in‐valve transcatheter aortic valve implantation for endocarditis degeneration , 2020, Journal of cardiac surgery.

[52]  D. Kolte,et al.  Urgent Balloon Aortic Valvuloplasty or Urgent TAVR in Patients With Severe Aortic Stenosis: A Propensity-Matched Analysis. , 2020, JACC. Cardiovascular interventions.

[53]  R. Cheng,et al.  Percutaneous Mitral Repair for Patients in Cardiogenic Shock Requiring Inotropes and Temporary Mechanical Circulatory Support. , 2019, JACC. Cardiovascular interventions.

[54]  A. Íñiguez,et al.  The European Registry of MitraClip in Acute Mitral Regurgitation following an acute myocardial infarction (EREMMI). , 2019, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[55]  C. Jung,et al.  Systematic Review and Meta-Analysis of Interventional Emergency Treatment of Decompensated Severe Aortic Stenosis. , 2019, The Journal of invasive cardiology.

[56]  Jeroen J. Bax,et al.  Contemporary Presentation and Management of Valvular Heart Disease: The EURObservational Research Programme Valvular Heart Disease II Survey. , 2019, Circulation.

[57]  C. Granger,et al.  Demographics, Care Patterns, and Outcomes of Patients Admitted to Cardiac Intensive Care Units: The Critical Care Cardiology Trials Network Prospective North American Multicenter Registry of Cardiac Critical Illness. , 2019, JAMA cardiology.

[58]  Y. Agmon,et al.  Salvage MitraClip in severe secondary mitral regurgitation complicating acute myocardial infarction: data from a multicentre international study , 2019, European journal of heart failure.

[59]  D. Tousoulis,et al.  Impella support following emergency percutaneous balloon aortic valvuloplasty in patients with severe aortic valve stenosis and cardiogenic shock. , 2019, Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese.

[60]  S. Kodali,et al.  Urgent transcatheter aortic valve replacement for severe acute aortic regurgitation following open mitral valve surgery , 2019, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[61]  S. Kapadia,et al.  Emergency valve‐in‐valve transcatheter aortic valve replacement in a patient with degenerated bioprosthetic aortic stenosis and cardiogenic shock on veno‐arterial extracorporeal membrane oxygenation , 2018, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[62]  G. Lemesle,et al.  Urgent balloon aortic valvuloplasty in patients with cardiogenic shock related to severe aortic stenosis: time matters. , 2018, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[63]  K. Gray,et al.  Mitral Valve-in-Valve Implantation as an Elective or Rescue Procedure in High-Risk Patients. , 2018, The Annals of thoracic surgery.

[64]  M. Leon,et al.  Valvular Heart Disease in Patients ≥80 Years of Age. , 2018, Journal of the American College of Cardiology.

[65]  G. Hanzel,et al.  Emergency Valve-in-Valve Transcatheter Aortic Valve Implantation for the Treatment of Acute Stentless Bioprosthetic Aortic Insufficiency and Cardiogenic Shock , 2018, Case reports in cardiology.

[66]  I. Palacios,et al.  Outcomes Following Urgent/Emergent Transcatheter Aortic Valve Replacement: Insights From the STS/ACC TVT Registry. , 2018, JACC. Cardiovascular interventions.

[67]  Isamu Mizote,et al.  A case of successful Mitraclip implantation in a patient having a large coaptation gap under extracorporeal membrane oxygenation (ECMO) , 2018, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[68]  C. Caussin,et al.  Transcatheter Aortic Valve Replacement for Severe Aortic Regurgitation With Acute Refractory Cardiogenic Shock. , 2017, The Canadian journal of cardiology.

[69]  A. Vahanian,et al.  Effectiveness of Rescue Percutaneous Balloon Aortic Valvuloplasty in Patients With Severe Aortic Stenosis and Acute Heart Failure. , 2017, The American journal of cardiology.

[70]  P. van der Harst,et al.  Emergency transcatheter aortic valve implantation in patients with severe aortic regurgitation and a left ventricle assist device: A case report and systematic review , 2017, European heart journal. Acute cardiovascular care.

[71]  V. von Dossow,et al.  Rescue TAVI for Aortic Regurgitation after Left Ventricular Assist Device Implantation Following Preoperative Impella® Support. , 2017, The Journal of heart valve disease.

[72]  Dustin W. Johnson,et al.  Use of Impella 5.0 Prior to Transcatheter Aortic Valve Replacement in a Patient with Severe Aortic Stenosis and Cardiogenic Shock. , 2017, The Journal of heart valve disease.

[73]  R. Lange,et al.  Emergency treatment of decompensated aortic stenosis , 2017, Heart.

[74]  M. Metra,et al.  Percutaneous edge-to-edge mitral valve repair for the treatment of acute mitral regurgitation complicating myocardial infarction: A single centre experience. , 2017, International journal of cardiology.

[75]  M. Enriquez-Sarano,et al.  The Course of Ischemic Mitral Regurgitation in Acute Myocardial Infarction After Primary Percutaneous Coronary Intervention: From Emergency Room to Long-Term Follow-Up , 2016, Circulation. Cardiovascular imaging.

[76]  R. Kornowski,et al.  Urgent Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Stenosis and Acute Heart Failure: Procedural and 30-Day Outcomes. , 2016, The Canadian journal of cardiology.

[77]  O. Booker,et al.  Emergent transcatheter mitral valve‐in‐valve implantation in a patient with cardiogenic shock secondary to a failed mitral bioprosthesis , 2016, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[78]  K. Kuck,et al.  Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis. , 2016, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[79]  RONGRONG SUN,et al.  Pathophysiology of valvular heart disease , 2016, Experimental and therapeutic medicine.

[80]  H. Eltchaninoff,et al.  Emergency Transcatheter Aortic Valve Implantation for Acute and Early Failure of Sutureless Perceval Aortic Valve. , 2015, The Canadian journal of cardiology.

[81]  X. Freixa,et al.  Percutaneous Mitral Valve Repair for Acute Mitral Regurgitation After an Acute Myocardial Infarction. , 2015, Journal of the American College of Cardiology.

[82]  R. Estévez-Loureiro,et al.  Percutaneous mitral valve repair with MitraClip system in a patient with acute mitral regurgitation after myocardial infarction. , 2015, Revista espanola de cardiologia.

[83]  M. Robbins,et al.  Transcatheter aortic valve replacement for aortic bioprosthetic valve failure with cardiogenic shock. , 2013, The Journal of invasive cardiology.

[84]  R. Hetzer,et al.  Transapical transcatheter aortic valve replacement in patients with cardiogenic shock. , 2012, Interactive cardiovascular and thoracic surgery.

[85]  M. Albertal,et al.  Life-saving percutaneous mitral valvuloplasty on a pregnant woman with refractory cardiogenic shock. , 2009, Heart, lung & circulation.

[86]  M. de Bonis,et al.  Mitral valve surgery in emergency for severe acute regurgitation: analysis of postoperative results from a multicentre study. , 2008, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[87]  Charanjit Singh,et al.  Life-saving PTMC for critical calcific mitral stenosis in cardiogenic shock with balloon impasse , 2003, International journal of cardiovascular interventions.

[88]  Assaf Bash,et al.  Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis: First Human Case Description , 2002, Circulation.

[89]  N. Hayat,et al.  Life-saving balloon mitral valvuloplasty in patient with cardiogenic shock after cardiac arrest. , 2001, The Journal of invasive cardiology.

[90]  B. Schorn,et al.  Efficacy of balloon valvuloplasty in patients with critical aortic stenosis and cardiogenic shock—the role of shock duration , 2001, Clinical cardiology.

[91]  P. Kerkar,et al.  Emergent balloon mitral valvotomy in patients presenting with cardiac arrest, cardiogenic shock or refractory pulmonary edema. , 1998, Journal of the American College of Cardiology.

[92]  I. Palacios,et al.  The role of percutaneous aortic balloon valvuloplasty in patients with cardiogenic shock and critical aortic stenosis. , 1994, Journal of the American College of Cardiology.

[93]  A. Cribier,et al.  Emergency balloon valvuloplasty as initial treatment of patients with aortic stenosis and cardiogenic shock. , 1992, The New England journal of medicine.

[94]  Thompson Me,et al.  Aortic stenosis in the elderly. , 1983, Geriatrics.

[95]  L. Cohn,et al.  Emergency aortic valve replacement. , 1976, American journal of surgery.

[96]  W. Daggett,et al.  Aortic Valve Surgery as an Emergency Procedure , 1970, Circulation.

[97]  J. Caro ESC/EACTS Guidelines on the management of valvular heart disease , 2012 .