Document Detail


Echocardiographic and clinical outcomes of central versus non-central percutaneous edge-to-edge repair of degenerative mitral regurgitation.
MedLine Citation:
PMID:  24013059     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: We aimed to assess the clinical and echocardiographic results of MitraClip implantation in non-central degenerative mitral regurgitation (dMR) compared to central dMR.
BACKGROUND: It is unknown if the use of the MitraClip therapy in non-central dMR is as safe and effective as in central dMR.
METHODS: We analyzed a multicentre registry of 173 patients treated with MitraClip and compared results of central and non-central dMR.
RESULTS: Seventy-nine patients (age 79.2±8.0 years, 58.2% males) had dMR. Forty-nine patients (62%) had central dMR with the remainder classified as non-central dMR (n=30, 38%). Patients with non-central dMR had a wider pre-procedural vena contracta (8.5±2.0 vs. 6.9±2.2 mm, p=0.039) and higher systolic pulmonary pressure (57.9±18.0 vs. 47.3±13.0 mmHg, p=0.019). Procedural success was the same in both groups (95.5% central vs. 96.7% non-central, p=0.866). Post-procedural MR and NYHA class at 1 month (MR≤2 96.0% vs. 96.6%, p=0.866 and NYHA ≤II 81.6% vs. 90.0%, p=0.335) and 6 months (95.2% central vs. 91.7% non-central, p=0.679; and NYHA class>II 21.1% vs. 0%. p=0.128) did not differ between groups. There were also no differences in serious post-procedural adverse events; partial clip detachment (central n=1 [2.0%] vs. non-central n=1 [3.3%], p=1.000), death (5.4% central vs. 13.0% non-central, p=0.298) or heart failure admission (10.8% central vs. 8.7% non-central, p=0.791).
CONCLUSION: In experienced centers, MitraClip treatment can be performed safe and effective in both central and non-central dMR.
Authors:
Rodrigo Estévez-Loureiro; Olaf Franzen; Reidar Winter; Lars Sondergaard; Per Jacobsen; Gary Cheung; Neil Moat; Nikolaj Ihlemann; Matteo Ghione; Susanna Price; Alison Duncan; Tine Streit Rosenberg; Sarah Barker; Carlo Di Mario; Magnus Settergren
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-30
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  -     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-9-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
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