JACC. Case reports · 2026
Debulking of the Mitral Valve: The Transseptal Approach.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Kücken Tanja, Huang Nora, Hölschermann Frank, Koban Cornel, Haase-Fielitz Anja, Neuß Michael, Butter Christian
Аннотация
BACKGROUND: Patients with thrombotic or infective masses on native or biological mitral valve have no established treatment if deemed ineligible for surgery. This case series summarizes our initial experience with a transseptal interventional bailout approach.
CASE SUMMARY: Seven high-risk patients (aged 74.0 ± 4.87 years; EuroSCORE II median 14.05%) underwent transseptal debulking under cerebral protection. Six procedures used the INARI system (FlowTriever; INARI Medical) and the TriClip system (Abbott). Debulking was technically successful in all patients, without stroke, valve injury, or relevant mitral regurgitation. In 3 patients with severe mitral stenosis (gradient 23.0 ± 2.6 mm Hg), gradients were reduced by 16.6 ± 2.1 mm Hg.
DISCUSSION: Transseptal aspiration using large-bore catheters appears feasible and safe in selected nonsurgical candidates with mitral valve-adherent masses.
TAKE-HOME MESSAGES: Transseptal aspiration of left-sided mitral valve-adherent masses is technically feasible in high-risk nonsurgical patients using large-bore steerable catheters and a cerebral protection system. This series suggests that thrombotic or infective masses on the mitral valve can be safely debulked through transseptal aspiration.
CASE SUMMARY: Seven high-risk patients (aged 74.0 ± 4.87 years; EuroSCORE II median 14.05%) underwent transseptal debulking under cerebral protection. Six procedures used the INARI system (FlowTriever; INARI Medical) and the TriClip system (Abbott). Debulking was technically successful in all patients, without stroke, valve injury, or relevant mitral regurgitation. In 3 patients with severe mitral stenosis (gradient 23.0 ± 2.6 mm Hg), gradients were reduced by 16.6 ± 2.1 mm Hg.
DISCUSSION: Transseptal aspiration using large-bore catheters appears feasible and safe in selected nonsurgical candidates with mitral valve-adherent masses.
TAKE-HOME MESSAGES: Transseptal aspiration of left-sided mitral valve-adherent masses is technically feasible in high-risk nonsurgical patients using large-bore steerable catheters and a cerebral protection system. This series suggests that thrombotic or infective masses on the mitral valve can be safely debulked through transseptal aspiration.