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Mitral valve repair using multiple MitraClips®: a dobutamine stress echocardiography evaluation.
MedLine Citation:
PMID:  23360653     Owner:  NLM     Status:  Publisher    
Aims: The haemodynamic effect of mitral valve (MV) repair using multiple MitraClips® (MC) has not been investigated. The aim of the study was to evaluate the stress performance of MV repair with MC. Methods and results: Twenty consecutive patients (77±7 years, 13 men [65%]) after implantation of >2 MitraClips® were subsequently evaluated with dobutamine stress echocardiography (DSE). After MC implantation, mean transmitral pressure gradient (TPG) (3.3±0.8 mmHg vs. 4.0±0.6 mmHg; p<0.001) and mitral valve orifice area (2.9±0.3 cm2 vs. 3.9±0.4 cm2; p<0.001) were significantly increased during DSE showing a physiological behaviour effect of the MV. LVEF (41±18% vs. 46±21%; p<0.001) and systolic pulmonary artery pressure (42±11 mmHg vs. 44±12 mmHg; p=0.014) increased significantly. The degree of MR was stable during stress (p=0.68). At linear regression, only baseline peak TPG was related to stress mean TPG (p<0.001; Beta 0.816; 95% CI: 0.368-0.918). Conclusions: MV repair using MitraClips® should be performed with the aim of maximal reduction of MR degree. MV repair using MC may not lead to pathological degrees of MV stenosis. Although the TPG is significantly increased during stress, it never reaches pathological levels and is always accompanied by a significant increase in MVOA. The degree of residual MR remains unchanged during maximal pharmacological stress.
Liliya Paranskaya; Giuseppe D'Ancona; Ilkay Bozdag-Turan; Stephan Kische; Ibrahim Akin; Gökmen R Turan; Jasmin Ortak; Jan Schuetz; Christoph A Nienaber; Hüseyin Ince
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-30
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  -     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Heart Center Rostock, University Hospital Rostock, Rostock, Germany.
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