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Impact of cleft-like indentations on procedural outcome of percutaneous edge-to-edge mitral valve repair.
Körber, Maria Isabel; Friedrichs, Kai Peter; Aydin, Fatma; Pfister, Roman; Mauri, Victor; Baldus, Stephan; Rudolph, Volker; Huntgeburth, Michael.
Afiliação
  • Körber MI; Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany.
  • Friedrichs KP; General and Interventional Cardiology, Heart & Diabetes Center NRW, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany.
  • Aydin F; Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany.
  • Pfister R; Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany.
  • Mauri V; Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany.
  • Baldus S; Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany.
  • Rudolph V; General and Interventional Cardiology, Heart & Diabetes Center NRW, University Hospital of the Ruhr-University Bochum, Bad Oeynhausen, Germany.
  • Huntgeburth M; Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany.
Catheter Cardiovasc Interv ; 97(6): 1236-1243, 2021 05 01.
Article em En | MEDLINE | ID: mdl-33002279
ABSTRACT
OBJECTIVES AND

BACKGROUND:

Percutaneous edge-to-edge mitral valve (MV) repair (PMVR) is broadly applied in high-risk patients with relevant mitral regurgitation (MR). We investigated the incidence of cleft-like indentations (CLI) and their impact on PMVR. METHODS AND

RESULTS:

In a retrospective single center analysis including 263 patients undergoing PMVR with the MitraClip®-system between 11/2012 and 7/2016, MV anatomy was assessed by 3-dimensional transesophageal echocardiography. CLI were present in 37/263 patients (14.1%). Of these, 62.2% had 1 CLI, 27% had 2 CLI, and 10.8% had 3 CLI, mostly concerning segment P2 or P2/3 of the MV. Baseline characteristics were similarly distributed. Interestingly, most patients with CLI suffered from secondary MR (n = 29, 78%). The number of deployed MitraClips was higher in patients with CLI (2 [1.25-2] vs. 2 [1, 2], p = .035), whereas procedural as well as clinical success was similar MR grade (1.2 vs. 1.5, p = .061), vena contracta width (4.2 vs. 4.5 mm, p = .293), dPmean (4.2 vs. 4.0 mmHg, p = .618) at discharge and NYHA class at 30 days did not differ between groups. Periprocedural complications were rare and equally distributed between groups. At 30 days, MR reduction persisted in patients with CLI (95.8% of these selected patients had a MR grade ≤ 2).

CONCLUSIONS:

CLI of the MV are common in patients undergoing PMVR, also when presenting mainly with secondary MR. While the number of clips needed to address MR is slightly higher in patients with CLI, procedural success rates appear not to be affected. PMVR seems to be a safe treatment option for patients with CLI.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Implante de Prótese de Valva Cardíaca / Insuficiência da Valva Mitral Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Implante de Prótese de Valva Cardíaca / Insuficiência da Valva Mitral Tipo de estudo: Observational_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article