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Lutter et al. Mini-invasive Surg 2020;4:36 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.15

Review Open Access

Transcatheter mitral valve implantation: different
fixation techniques

Georg Lutter , Derk Frank , Jan Hinnerk Hansen , Yazhou Liu , Jochen Cremer , Assad Haneya ,
1
1
1
3
2
1
Thomas Puehler 1
1 Department of Cardiovascular Surgery, University of Kiel, School of Medicine, Kiel 24105, Germany.
2 Department of Cardiology and Angiology, Christian-Albrechts-University of Kiel, Kiel 24105, Germany.
3 Department of Pediatric Cardiology, University of Kiel, School of Medicine, Kiel 24105, Germany.
Correspondence to: Georg Lutter, Department of Experimental Cardiac Surgery and Heart Valve Replacement, University of
Kiel, School of Medicine, Arnold-Heller-Straße 3, Kiel 24105, Germany. E-mail: georg.lutter@uksh.de
How to cite this article: Lutter G, Frank D, Hansen JH, Liu Y, Cremer J, Haneya A, Puehler T. Transcatheter mitral valve
implantation: different fixation techniques. Mini-invasive Surg 2020;4:36. http://dx.doi.org/10.20517/2574-1225.2020.15
Received: 26 Jan 2020 First Decision: 19 Mar 2020 Revised: 14 Apr 2020 Accepted: 13 May 2020 Published: 18 Jun 2020

Science Editor: Giulio Belli Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Transcatheter mitral valve implantation provides an off-pump treatment option for mitral valve regurgitation,
especially for secondary mitral regurgitation. It offers an opportunity for the treatment of a large cohort of patients
not referred for conventional surgery. One of the biggest challenges is the development of a valved stent that
suits the complex anatomy of the native mitral valve. Furthermore, secure anchorage of the device is difficult in
the mitral area without clearly defined structures. In the last few years, various new self-expanding nitinol valved
stents for transapical implantation in the beating heart have been developed. Different design iterations were
conducted to improve fixation and overall stent performance. The risk of paravalvular leakage was decreased and
reproducibility enhanced. This article reviews the major achievements in the development process of our apically
fixed mitral valved stent over the last few years, with prototypes that provide secure stent deployment, high
reproducibility and low paravalvular leakage rates.

Keywords: Mitral valve, transcatheter, valved stent, off-pump, fixation techniques

INTRODUCTION
The development of transcatheter mitral valve implantation is the focus of recent research. This novel
procedure provides a means to treat severe and symptomatic mitral insufficiency, especially secondary mitral
regurgitation, without the need for ECMO during surgery. The transcatheter mitral valve implantation device
includes heart valved stents that are implanted into the beating heart using a transcatheter-guided technique.
This novel technology is ideal, especially for older patients, who are classified as high-risk patients or not

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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