Yohei Ohno1, Guilherme F Attizzani2, Davide Capodanno3, Stefano Cannata4, Fabio Dipasqua4, Sebastiano Immé4, Marco Barbanti4, Margherita Ministeri4, Anna Caggegi4, Anna M Pistritto4, Marta Chiarandà4, Giuseppe Ronsivalle4, Sandra Giaquinta4, Silvia Farruggio4, Sarah Mangiafico4, Salvatore Scandura4, Corrado Tamburino3, Piera Capranzano3, Carmelo Grasso5. 1. Department of Cardiology, Ferrarotto Hospital, University of Catania, Via Citelli 29, Catania 95124, Italy Department of Cardiology, University of Tokai School of Medicine, Isehara, Japan. 2. Department of Cardiology, Ferrarotto Hospital, University of Catania, Via Citelli 29, Catania 95124, Italy Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio, USA Department of Interventional Cardiology, Pitangueiras Hospital, Jundiai, Brazil. 3. Department of Cardiology, Ferrarotto Hospital, University of Catania, Via Citelli 29, Catania 95124, Italy Excellence Through Newest Advances (ETNA) Foundation, Catania, Italy. 4. Department of Cardiology, Ferrarotto Hospital, University of Catania, Via Citelli 29, Catania 95124, Italy. 5. Department of Cardiology, Ferrarotto Hospital, University of Catania, Via Citelli 29, Catania 95124, Italy melfat75@gmail.com.
Abstract
AIM: The aim of this study was to evaluate the association of baseline tricuspid regurgitation (TR) on the outcomes after percutaneous mitral valve repair (PMVR) with the MitraClip system. METHODS AND RESULTS: Data from 146 consecutive patients with functional mitral regurgitation (MR) were obtained. Two different groups, dichotomized according to the degree of pre-procedural TR (moderate/severe, n = 47 and none/mild, n = 99), had their clinical and echocardiographic outcomes through 12-month compared. At 30-day, the primary safety endpoint was significantly higher in moderate/severe TR compared with none/mild TR (10.6 vs. 2.0%, P = 0.035). Marked reduction in MR grades observed post-procedure were maintained through 12 months. Although NYHA functional class significantly improved in both groups compared with baseline, it was impaired in moderate/severe TR compared with the none/mild TR group (NYHA > II at 30 day: 33.3 vs. 9.2%, P < 0.001; at 1 year: 38.5 vs. 12.3%, respectively, P = 0.006). Left ventricle reverse remodelling and ejection fraction improvement were revealed in both groups. The primary efficacy endpoint at 12-month determined by freedom from death, surgery for mitral valve dysfunction, or grade ≥ 3+ MR was comparable between groups, but combined death and re-hospitalization for heart failure rates were higher in the moderate/severe TR group. Multivariable Cox regression analysis demonstrated that baseline moderate/severe TR and chronic kidney disease were independent predictors of this combined endpoint. CONCLUSIONS: Although PMVR with MitraClip led to improvement in MR, TR, and NYHA functional class in patients with baseline moderate/severe TR, the primary safety endpoint at 30-day was impaired, while moderate/severe TR independently predicted death and re-hospitalization for heart failure at 12-month. Published on behalf of the European Society of Cardiology. All rights reserved.
AIM: The aim of this study was to evaluate the association of baseline tricuspid regurgitation (TR) on the outcomes after percutaneous mitral valve repair (PMVR) with the MitraClip system. METHODS AND RESULTS: Data from 146 consecutive patients with functional mitral regurgitation (MR) were obtained. Two different groups, dichotomized according to the degree of pre-procedural TR (moderate/severe, n = 47 and none/mild, n = 99), had their clinical and echocardiographic outcomes through 12-month compared. At 30-day, the primary safety endpoint was significantly higher in moderate/severe TR compared with none/mild TR (10.6 vs. 2.0%, P = 0.035). Marked reduction in MR grades observed post-procedure were maintained through 12 months. Although NYHA functional class significantly improved in both groups compared with baseline, it was impaired in moderate/severe TR compared with the none/mild TR group (NYHA > II at 30 day: 33.3 vs. 9.2%, P < 0.001; at 1 year: 38.5 vs. 12.3%, respectively, P = 0.006). Left ventricle reverse remodelling and ejection fraction improvement were revealed in both groups. The primary efficacy endpoint at 12-month determined by freedom from death, surgery for mitral valve dysfunction, or grade ≥ 3+ MR was comparable between groups, but combined death and re-hospitalization for heart failure rates were higher in the moderate/severe TR group. Multivariable Cox regression analysis demonstrated that baseline moderate/severe TR and chronic kidney disease were independent predictors of this combined endpoint. CONCLUSIONS: Although PMVR with MitraClip led to improvement in MR, TR, and NYHA functional class in patients with baseline moderate/severe TR, the primary safety endpoint at 30-day was impaired, while moderate/severe TR independently predicted death and re-hospitalization for heart failure at 12-month. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Robert Schueler; Can Öztürk; Jan-Malte Sinning; Nikos Werner; Armin Welz; Christoph Hammerstingl; Georg Nickenig Journal: Clin Res Cardiol Date: 2016-12-21 Impact factor: 5.460
Authors: Alexander A Brescia; Sarah T Ward; Tessa M F Watt; Liza M Rosenbloom; Megan Baker; Shazli Khan; Emilie Ziese; Matthew A Romano; Steven F Bolling Journal: Ann Thorac Surg Date: 2019-08-31 Impact factor: 4.330
Authors: Anthony Alozie; Liliya Paranskaya; Bernd Westphal; Alexander Kaminski; Mohammad Sherif; Magnus Sindt; Stephan Kische; Jochen Schubert; Doreen Diedrich; Hüseyin Ince; Gustav Steinhoff; Alper Öner Journal: BMC Cardiovasc Disord Date: 2017-03-20 Impact factor: 2.298