Cheng Hsin General Hospital Innovates Anterior Mitral Leaflet Cutting Technique, Enhancing TMVR Outcomes and Gaining Global Recognition

At the world’s largest interventional treatment conference, EuroPCR, on May 15, 2024, Vice Superintendent Yin Wei Hsian presented Cheng Hsin General Hospital’s pioneering modified anterior mitral leaflet cutting technique (Tip-to-base LAMPOON technique). This innovation prevents left ventricular outflow tract obstruction, significantly improving the outcomes of transcatheter mitral valve replacement (TMVR).

Transcatheter Mitral Valve Replacement (TMVR): Enabling Safe and Rapid Recovery for Elderly Patients and Those with Multiple Comorbidities

Over the past two decades, many patients with severe mitral valve disease have undergone surgical mitral valve replacement or annuloplasty. However, implanted bioprosthetic valves, like worn-out shoes, gradually deteriorate over time. When valve deterioration occurs, the standard treatment is another surgical valve replacement. Yet, many patients, due to advanced age, multiple comorbidities, or frailty, are unsuitable for repeat surgery. At this point, TMVR brings hope to these patients.

Cheng Hsin General Hospital: Over 100 TMVR Procedures Completed, Serving as Asia’s Teaching Center for Transcatheter Valve Disease Treatment

European and American countries approved this procedure about ten years ago. Our hospital, having a large number of patients who previously underwent surgical valve replacement or annuloplasty, began offering this treatment eight years ago to help those in need. Over the past few years, our hospital has performed more than 100 TMVR procedures. Due to our extensive experience, we have the highest number of cases in Southeast Asia at a single center, with outstanding procedural achievements. Earlier this year, Edwards Lifesciences, an American valve company designated our hospital as Asia’s teaching center for transcatheter valve disease treatment, and we have begun training physicians from Malaysia, Thailand, Vietnam, and other countries.

Our Hospital’s Valve Team Pioneers Modified Anterior Mitral Leaflet Cutting Technique (Tip-to-base LAMPOON technique), Significantly Improving TMVR Outcomes

According to international reports, the most severe complication of TMVR is the implanted valve obstructing the heart’s outflow, leading to procedural failure. This is especially common in patients who have previously undergone surgical mitral valve annuloplasty. Consequently, many patients could not receive catheter treatment, or the outcomes were less than ideal even if they did.

To overcome this surgical challenge, our valve team, under Superintendent Wei’s leadership, brainstormed and simplified the critical technique to prevent the implanted valve from obstructing the heart’s outflow. This significantly improved TMVR outcomes, raising the success rate from approximately 80% reported internationally to 91%. This breakthrough is the first of its kind in overcoming the difficulties of TMVR. The results were presented at this year’s EuroPCR conference and received recognition from experts worldwide.