Medtronic Gives First Look at its Transcatheter Mitral Valve
by Chris Wiltz on October 28, 2013
Attendees of the 25th annual TCT Conference were given a first look at Medtronic's new transcatheter mitral valve.
Attendees of the 25th annual TCT Conference were given a first look at Medtronic's new transcatheter mitral valve. Dr. Nicolo Paizza of the McGill University Health Center in Montreal, Canada and the German Heart Center in Munich, and consultant to Medtronic, was on hand to deliver details and the results of two animal studies.
Piazza outlined the challenges in designing a transcatheter mitral valve “There's high transvalvular gradients, there's a dynamic environment, we have to avoid the submitral apparatus, there's absence of calcium, there's a large angular range as opposed to the transcatheter aortic valve implantation. And there's a large effective orifice area as well.”
Piazza continues, “The last two in combination mean we're dealing with higher dislodgement forces. Because of the large angular range we're dealing with larger delivery catheters. And we have to make sure our valves are able to treat different types of mitral valve pathology.”
Medtronic's new valve (no product name for the device was given) features a large inflow atrial portion that is responsible for sealing and a short outflow ventricular portion in order to avoid obstruction. It has support arms that function to capture the anterior and posterior mitral valve leaflet and does not rely on radial forces for anchoring, and instead uses the submitral apparatus for axial anchoring.
|Medtronic's new transcatheter mitral valve (Image courtesy Nicolo Piazza / TCT Conference)
Piazza showed an animation as well as animal test footage demonstrating the implantation. The delivery catheter passes the mitral valve, the catheter is oriented so that support arms come out, the delivery catheters are retracted and and once positioning is confirmed (using a combination of fluoroscopic and echocardiographic guidance as well as tactile feedback) the atrial portion is then released.
There's also a new feature Medtronic is very excited about because, as Piazza puts it, “the more and more you deal with this field, you learn never to say never.” The valve is fully retrievable and can be refolded and withdrawn via a catheter in case a bailout procedure is needed.
Acute animal studies have shown the valve to be user friendly and easy to implant and contrast left ventriculography (LV gram) have shown no central or paravular leaks, no left ventricular tract obstructions, and no transvavular gradients. “Chronic animal studies have also demonstrated long term device performance,” Piazza adds.
Correction: A previous version of this article incorrectly idenfitied Dr. Piazza as being part of the German Heart Center in Montreal, Canada. The German Heart Center is in Munich.
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