Document Detail


Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction.
MedLine Citation:
PMID:  20219746     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS: We sought to assess the feasibility of catheter-based mitral valve repair using the MitraClip system in high-surgical-risk patients with mitral regurgitation (MR) > or =grade 3+.
METHODS AND RESULTS: MitraClip therapy was performed in 51 consecutive patients [73 +/- 10 years; 34 (67%) men] with symptomatic functional [n = 35 (69%)] or organic MR [n = 16 (31%)]. Mean logistic EuroSCORE was 29 +/- 22%; Society of Thoracic Surgeons score was 15 +/- 11. Left ventricular (LV) ejection fraction was 36 +/- 17%. In 35 patients (69%), adverse mitral valve morphology and/or severe LV dysfunction were present. MitraClip implantation was successful in 49 patients (96%). Most patients [n = 34/49 (69%)] were treated with a single clip, whereas 14 patients (29%) received two clips and one patient received three clips. Mean device and fluoroscopy times were 105 +/- 65 min and 44 +/- 28 min, respectively. Procedure-related reduction in MR severity was one grade in 16 patients (31%), two grades in 24 patients (47%), and three grades in 9 patients (18%). Forty-four of the 49 successfully treated patients (90%) showed clinical improvement at discharge [NYHA functional class > or =III in 48 patients (98%) before and 16 patients (33%) after the procedure (P < 0.0001)]. There were no procedure-related major adverse events and no in-hospital mortality.
CONCLUSION: Mitral valve repair using the MitraClip system was shown to be feasible in patients at high surgical risk primarily determined by an adverse mitral valve morphology and/or severe LV dysfunction.
Authors:
Olaf Franzen; Stephan Baldus; Volker Rudolph; Sven Meyer; Malgorzata Knap; Dietmar Koschyk; Hendrik Treede; Achim Barmeyer; Joachim Schofer; Angelika Costard-Jäckle; Michael Schlüter; Hermann Reichenspurner; Thomas Meinertz
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Publication Detail:
Type:  Journal Article     Date:  2010-03-10
Journal Detail:
Title:  European heart journal     Volume:  31     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1373-81     Citation Subset:  IM    
Affiliation:
Department of General and Interventional Cardiology, University Heart Centre, Hamburg, Germany. owfranzen@gmx.de
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Comment In:
Eur Heart J. 2010 Jun;31(11):1301-4   [PMID:  20385570 ]

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