Isaac Pascual1, Dabit Arzamendi2, Fernando Carrasco-Chinchilla3, Felipe Fernández-Vázquez4, Xavier Freixa5, Luis Nombela-Franco6, Pablo Avanzas7, Ana María Serrador Frutos8, Manuel Pan9, Ana Belén Cid Álvarez10, Rosa Ana Hernández-Antolín11, Leire Andraka Ikazuriaga12, Ignacio Cruz-González13, José Luis Díez Gil14, María Soledad Alcasena Juango15, Alberto Berenguer Jofresa16, Juan H Alonso-Briales3, Chi Hion Li2, Tomás Benito González4, Ander Regueiro5, Germán Armijo6, Víctor León17, Ignacio J Amat-Santos8, Miguel Romero9, Ramiro Trillo Nouche10, Covadonga Fernández-Golfín11, Lara Ruiz Gómez12, Rafael Campos-Arjona3, Xavier Millán2, Carmen Garrote Coloma4, Laura Sanchis5, Pilar Jiménez-Quevedo6, César Morís1, José María Hernández-García3, Antonio Serra2, Armando Pérez de Prado4, Rodrigo Estévez-Loureiro18. 1. Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, Spain. 2. Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 3. Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. 4. Servicio de Cardiología, Complejo Hospitalario de León, León, Spain. 5. Servicio de Cardiología, Institut Clínic Cardiovascular, Hospital Clínic de Barcelona, Barcelona, Spain. 6. Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. 7. Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain; Departamento de Biología Funcional, Universidad de Oviedo, Oviedo, Asturias, Spain. Electronic address: avanzas@gmail.com. 8. Instituto de Ciencias del Corazón, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. 9. Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. 10. Servicio de Cardiología, Complejo Hospitalario Universitario Santiago de Compostela, CIBERCV, Santiago de Compostela, A Coruña, Spain. 11. Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain. 12. Servicio de Cardiología, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain. 13. Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain. 14. Servicio de Cardiología, Hospital Universitario y Politécnico La Fe de Valencia, Valencia, Spain. 15. Área Clínica del Corazón, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain. 16. Servicio de Cardiología, Hospital General de Valencia, Valencia, Spain. 17. Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain. 18. Área de Cardiología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain.
Abstract
INTRODUCTION AND OBJECTIVES: Transcatheter mitral valve repair (TMVR) with MitraClip is a therapeutic option for high surgical risk patients with severe mitral regurgitation (MR). The main objective of this study was to analyze differences in outcomes in patients with severe MR according to the cause of MR. METHODS: Observational, multicenter, and prospective study with consecutive patient inclusion. The primary endpoint was the combination of all-cause mortality and new readmissions due to heart failure after 1 year. We compared clinical and procedural characteristics and the event rate for each MR group. We performed a multivariate analysis to identify predictive variables for the primary endpoint. RESULTS: A total of 558 patients were included: 364 (65.2%) with functional etiology, 111 (19.9%) degenerative and 83 (14.9%) mixed. The mean age was 72.8±11.1 years and 70.3% of the sample were men. There were 95 (17%) events in the overall sample. No significant differences were found in the 3 groups in the number of primary outcome events: 11 (11.3%) in degenerative MR, 71 (21.3%) in functional MR, and 13 (18.1%) in mixed MR (P=.101). Independent predictors were functional class (P=.029), previous surgical revascularization (P=.031), EuroSCORE II (P=.003), diabetes mellitus (P=.037), and left ventricular ejection fraction (P=.015). CONCLUSIONS: This study confirms the safety and efficacy of TMVR with MitraClip irrespective of MR etiology in real-life data and shows the main factors related to prognosis during the first year of follow up.
INTRODUCTION AND OBJECTIVES: Transcatheter mitral valve repair (TMVR) with MitraClip is a therapeutic option for high surgical risk patients with severe mitral regurgitation (MR). The main objective of this study was to analyze differences in outcomes in patients with severe MR according to the cause of MR. METHODS: Observational, multicenter, and prospective study with consecutive patient inclusion. The primary endpoint was the combination of all-cause mortality and new readmissions due to heart failure after 1 year. We compared clinical and procedural characteristics and the event rate for each MR group. We performed a multivariate analysis to identify predictive variables for the primary endpoint. RESULTS: A total of 558 patients were included: 364 (65.2%) with functional etiology, 111 (19.9%) degenerative and 83 (14.9%) mixed. The mean age was 72.8±11.1 years and 70.3% of the sample were men. There were 95 (17%) events in the overall sample. No significant differences were found in the 3 groups in the number of primary outcome events: 11 (11.3%) in degenerative MR, 71 (21.3%) in functional MR, and 13 (18.1%) in mixed MR (P=.101). Independent predictors were functional class (P=.029), previous surgical revascularization (P=.031), EuroSCORE II (P=.003), diabetes mellitus (P=.037), and left ventricular ejection fraction (P=.015). CONCLUSIONS: This study confirms the safety and efficacy of TMVR with MitraClip irrespective of MR etiology in real-life data and shows the main factors related to prognosis during the first year of follow up.
Authors: Daniel Henández-Vaquero; Isaac Pascual; Marcel Almendarez; Antonio Adeba; Alberto Alperi; Rebeca Lorca; Héctor Cubero-Gallego; Víctor León; Félix E Fernández Suárez; David Fernández Del Valle; César Morís; Pablo Avanzas Journal: Ann Transl Med Date: 2020-08
Authors: Isaac Pascual; Tomás Benito-González; Daniel Hernandez-Vaquero; Rodrigo Estévez-Loureiro; Rebeca Lorca; Carmen Garrote-Coloma; Pablo Avanzas; Javier Gualis; Antonio Adeba; Armando Pérez de Prado; César Morís; Felipe Fernández-Vázquez Journal: Ann Transl Med Date: 2020-08
Authors: Hector Cubero-Gallego; Daniel Hernandez-Vaquero; Pablo Avanzas; Marcel Almendarez; Antonio Adeba; Rebeca Lorca; Jose Rozado; Alain Escalera; Jacobo Silva; Cesar Moris; Isaac Pascual Journal: Ann Transl Med Date: 2020-08
Authors: Alberto Alperi; Pablo Avanzas; Isaac Pascual; Antonio Adeba; Rebeca Lorca; Victor León; Marcel Almendarez; Hector Cubero-Gallego; Iria Silva-Conde; César Moris; Daniel Hernandez-Vaquero Journal: Ann Transl Med Date: 2020-08