Predictors for long-term survival after transcatheter edge-to-edge mitral valve repair.
J Interv Cardiol
; 30(3): 226-233, 2017 Jun.
Article
en En
| MEDLINE
| ID: mdl-28370526
ABSTRACT
OBJECTIVES:
To determine predictors for long-term outcome in high-risk patients undergoing transcatheter edge-to-edge mitral valve repair (TMVR) for severe mitral regurgitation (MR).BACKGROUND:
There is no data on predictors of long-term outcome in high-risk real-world patients.METHODS:
From August 2009 to April 2011, 126 high-risk patients deemed inoperable were treated with TMVR in two high-volume university centers.RESULTS:
MR could be successfully reduced to grade ≤2 in 92.1% of patients (116/126 patients). Long-term clinical follow-up up to 5 years (95.2% follow-up rate) revealed a mortality rate of 35.7% (45/126 patients). Repeat mitral valve treatment (surgery or intervention) was needed in 19 patients (15.1%). Long-term clinical improvement was demonstrated with 69% of patients being in NYHA class ≤II. In a multivariable Cox regression analysis, the post-procedural grade of MR (hazard ratio [HR] 1.55 per grade, P = 0.035), the left ventricular ejection fraction (HR 0.58 for difference between 75th and 25th percentile, P = 0.031) and the glomerular filtration rate (HR 0.33 for 75th vs 25th percentile, P < 0.001) were independent predictors for long-term mortality. Patients with primary MR and a post-procedural MR grade ≤1 had the most favorable long-term outcome.CONCLUSIONS:
This study determines predictors of long-term clinical outcome after TMVR and demonstrates that the grade of residual MR determines long-term survival. Our data suggest that it might be of benefit reducing residual MR to the lowest possible MR grade using TMVR-especially in selected high-risk patients with primary MR who are not considered as candidates for surgical MVR.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Cateterismo Cardíaco
/
Implantación de Prótesis de Válvulas Cardíacas
/
Efectos Adversos a Largo Plazo
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Válvula Mitral
/
Insuficiencia de la Válvula Mitral
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Interv Cardiol
Asunto de la revista:
CARDIOLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Alemania