Why the study?
Severe mitral annulus calcification is increasing in older adults, surgical techniques are technically demanding, and up to one-third of patients are considered too high risk for conventional surgery.
Case Report (n=5)
No
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The coulisse technique for open transcatheter mitral valve implantation provides a viable option for high-risk patients with severe mitral annulus calcification, reducing risks of LVOT obstruction and paravalvular leak.
Because of the growing population of older adult patients, the prevalence of severe mitral annulus calcification ("big MAC") is increasing. The surgical techniques used to treat big MACs are technically demanding; despite the technical aspect, up to one-third of patients are considered too high risk for conventional surgery but are candidates for the coulisse technique, which is a procedure that implants a transcatheter valve into a native mitral annulus. The anterior leaflet is unfolded, thus reducing the risk of obstructing the left ventricular outflow tract and for paravalvular leak and avoiding valve migration. Preoperative planning, based on a computed tomography scan, is mandatory.
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Stelzmueller et al. (2022) conducted a case report in Severe mitral annulus calcification (big MAC) (n=5). Open transcatheter mitral valve implantation using the coulisse technique was evaluated on Survival and valve performance (paravalvular leakage, valve migration, LVOT obstruction).
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