title: Transcatheter mitral valve replacement with a novel self-expandable prosthesis: single institutional experience procedural outcomes and follow-up.
abstract: OBJECTIVE
  We report our experience with the CardiAQ prosthetic valve using both transapical and transseptal access. Aim of our study was proving the feasibility, safety and effectiveness of a novel transcatheter mitral valve bioprosthesis.
  
  
  METHODS
  Four patients with severe mitral regurgitation, not eligible for mitral valve surgery, were treated with the CardiAQ valve. The procedures were performed under general anaesthesia, fluoroscopic and transesophageal echocardiographic guidance. We used a transapical approach in two patients and transseptal access in the others.
  
  
  RESULTS
  Procedural success was obtained in all patients without extracorporeal circulation support. Mean procedure time was 128 min (range 90-180) and mean hospitalization duration was 12 days (range 4-24). The transseptal approach resulted in significantly shorter in-hospital stay with quick recovery. One patient died on day 35 from septicaemia and another one died after 5 months from major bleeding. The survival patients are presently in New York Heart Association I-II with improved left ventricular ejection fraction and normal quality of life.
  
  
  CONCLUSIONS
  CardiAQ valve placement is safe using a transapical or transseptal approach. Following valve replacement, there was a marked functional improvement in survivors. Transcatheter mitral valve replacement is a promising therapy for mitral regurgitation in a selected patient population.
authors.affiliation: aDepartment of Medicine, Università degli Studi di Roma 'Tor Vergata', Rome, Italy bDepartment of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA cDebakey Cardiovascular Institute Houston Methodist Hospital, Houston, Texas, USA dDepartment of Surgery Università degli Studi di Roma 'Tor Vergata', Rome, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ussia
authors.forename: Valeria
authors.initials: V
authors.lastname: Cammalleri
authors.forename: Jawahar L
authors.initials: JL
authors.lastname: Mehta
authors.forename: Kunal
authors.initials: K
authors.lastname: Sarkar
authors.forename: Saverio
authors.initials: S
authors.lastname: Muscoli
authors.forename: Pasquale
authors.initials: P
authors.lastname: de Vico
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ruvolo
authors.forename: Francesco
authors.initials: F
authors.lastname: Romeo
mesh_terms: D000368:Aged; D001705:Bioprosthesis; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000209:etiology; D011474:Prosthesis Design / Q000295:instrumentation*; D011475:Prosthesis Failure; D018805:Sepsis / Q000209:etiology; D016896:Treatment Outcome