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Acute effect of percutaneous MitraClip therapy in patients with haemodynamic decompensation.
MedLine Citation:
PMID:  22588322     Owner:  NLM     Status:  Publisher    
AIMS: To evaluate the haemodynamic effect of acute procedural success (APS) after MitraClip therapy in patients with haemodynamic decompensation. METHODS AND RESULTS: Of 107 patients, 79 achieved APS after MitraClip implantation. The increase in cardiac index (CI) was primarily detected in patients with a low baseline CI (2.0 ± 0.5 to 2.5 ± 5 L/min/m(2), P < 0.001). There was a decrease in left ventricular end-diastolic pressure (LVEDP) (20 ± 5 to 13 ± 5 mmHg, P = 0.002) and mean pulmonary capillary wedge pressure (PCWPm) (20 ± 4 to 16 ± 5 mmHg, P = 0.001) in patients with values >15 mmHg at baseline, and a decrease in mean pulmonary artery systolic (PAPm) (36 ± 4 to 29 ± 7 mmHg P = 0.003) in those with values >30 mmHg before the MitraClip procedure. Patients with decompensation compared with patients with compensation experienced significant reduction in LVEDP (-8.3 ± 11.9 mmHg vs. -0.2 ± 4.5 mmHg, P = 0.009), a reduction in PCWPm (-3.5 ± 5.6 mmHg vs. 1.9 ± 4.7 mmHg, P < 0.001), and a reduction in PAPm (-8 ± 9 mmHg vs. 3 ± 6 mmHg, P < 0.001). CONCLUSION: The favourable haemodynamic effects of MitraClip therapy on CI were primarily detected in patients with low CI before the procedure, and improvements in left-sided filling pressure and PAP were primarily seen in those with elevated values at baseline.
Simon Biner; Robert J Siegel; Ted Feldman; Asim M Rafique; Alfredo Trento; Patrick Whitlow; Jason Rogers; Marc Moon; Brian Lindman; Alan Zajarias; Donald Glower; Saibal Kar;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-14
Journal Detail:
Title:  European journal of heart failure     Volume:  -     ISSN:  1879-0844     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Cedars-Sinai Heart Institute, Los Angeles, CA 90048, USA.
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