OBJECTIVES: This study sought to assess the feasibility and safety of percutaneous edge-to-edge mitral valve (MV) repair in patients with an unacceptably high operative risk. BACKGROUND: MV repair for mitral regurgitation (MR) can be accomplished by use of a clip that approximates the free edges of the mitral leaflets. METHODS: All patients were declined for surgery because of a high logistic EuroSCORE (>20%) or the presence of other specific surgical risk factors. Transthoracic echocardiography was performed before and 6 months after the procedure. Differences in New York Heart Association (NYHA) functional class, quality of life (QoL) using the Minnesota questionnaire, and 6-min walk test (6-MWT) distances were reported. RESULTS: Fifty-five procedures were performed in 52 patients (69.2% male, age 73.2 ± 10.1 years, logistic EuroSCORE 27.1 ± 17.0%). In 3 patients, partial clip detachment occurred; a second clip was placed successfully. One patient experienced cardiac tamponade. Two patients developed inguinal bleeding, of whom 1 needed surgery. Six patients (11.5%) died during 6-month follow-up (5 patients as a result of progressive heart failure and 1 noncardiac death). The MR grade before repair was ≥3 in 100%; after 6 months, a reduction in MR grade to ≤2 was present in 79% of the patients. Left ventricular (LV) end-diastolic diameter, LV ejection fraction, and systolic pulmonary artery pressure improved significantly. Accompanied improvements in NYHA functional class, QoL index, 6-MWT distances, and log N-terminal pro-B-type natriuretic peptide were observed. CONCLUSIONS: In a high-risk population, MR reduction can be achieved by percutaneous edge-to-edge valve repair, resulting in LV remodeling with improvement of functional capacity after 6 months.
OBJECTIVES: This study sought to assess the feasibility and safety of percutaneous edge-to-edge mitral valve (MV) repair in patients with an unacceptably high operative risk. BACKGROUND: MV repair for mitral regurgitation (MR) can be accomplished by use of a clip that approximates the free edges of the mitral leaflets. METHODS: All patients were declined for surgery because of a high logistic EuroSCORE (>20%) or the presence of other specific surgical risk factors. Transthoracic echocardiography was performed before and 6 months after the procedure. Differences in New York Heart Association (NYHA) functional class, quality of life (QoL) using the Minnesota questionnaire, and 6-min walk test (6-MWT) distances were reported. RESULTS: Fifty-five procedures were performed in 52 patients (69.2% male, age 73.2 ± 10.1 years, logistic EuroSCORE 27.1 ± 17.0%). In 3 patients, partial clip detachment occurred; a second clip was placed successfully. One patient experienced cardiac tamponade. Two patients developed inguinal bleeding, of whom 1 needed surgery. Six patients (11.5%) died during 6-month follow-up (5 patients as a result of progressive heart failure and 1 noncardiac death). The MR grade before repair was ≥3 in 100%; after 6 months, a reduction in MR grade to ≤2 was present in 79% of the patients. Left ventricular (LV) end-diastolic diameter, LV ejection fraction, and systolic pulmonary artery pressure improved significantly. Accompanied improvements in NYHA functional class, QoL index, 6-MWT distances, and log N-terminal pro-B-type natriuretic peptide were observed. CONCLUSIONS: In a high-risk population, MR reduction can be achieved by percutaneous edge-to-edge valve repair, resulting in LV remodeling with improvement of functional capacity after 6 months.
Authors: Friso A Kortlandt; Thomas de Beenhouwer; Martin J Swaans; Marco C Post; Jan A S van der Heyden; Frank D Eefting; Benno J W M Rensing Journal: Cardiovasc Diagn Ther Date: 2016-04
Authors: José Airton de Arruda; Viviana de Mello Guzzo Lemke; José Mariani Júnior; Adriano Henrique Pereira Barbosa; Alexandre Schaan de Quadros; Carlos Augusto Cardoso Pedra; Cristiano de Oliveira Cardoso; Ênio Eduardo Guérios; Henrique Barbosa Ribeiro; Luiz Antonio Gubolino; Maurício Cavalieri Machado; Mauricio Jaramillo Hincapie; Nelson Antonio Moura de Araujo; Raul Ivo Rossi Filho; Ricardo Alves da Costa; Silvio Gioppato Journal: Arq Bras Cardiol Date: 2020-01 Impact factor: 2.000
Authors: Z Rahhab; F A Kortlandt; J F Velu; R A J Schurer; V Delgado; P Tonino; A J Boven; B J L Van den Branden; A O Kraaijeveld; M Voskuil; J Hoorntje; M van Wely; K van Houwelingen; G B Bleeker; B Rensing; I Kardys; J Baan; J A S Van der Heyden; N M Van Mieghem Journal: Neth Heart J Date: 2017-06 Impact factor: 2.380
Authors: F A Kortlandt; C C van 't Klooster; A L M Bakker; M J Swaans; J C Kelder; T L de Kroon; B J W M Rensing; F D Eefting; J A S van der Heyden; M C Post Journal: Neth Heart J Date: 2016-07 Impact factor: 2.380