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Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome.

Toggweiler S, Zuber M, Sürder D, Biaggi P, Gstrein C, Moccetti T, Pasotti E, Gaemperli O, Faletra F, Petrova-Slater I, Grünenfelder J, Jamshidi P, Corti R, Pedrazzini G, Lüscher TF, Erne P - Open Heart (2014)

Bottom Line: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year.Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

View Article: PubMed Central - PubMed

Affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland.

ABSTRACT

Objective: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.

Methods: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively.

Results: A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m(2) at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival.

Conclusions: A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m(2), the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

No MeSH data available.


Related in: MedlinePlus

NYHA class over the 2-year study period. At 2 years, 53% of patients were in NYHA class I or II, 19% were in class III and 3% in class IV. BL, baseline; NYHA, New York Heart Association.
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OPENHRT2014000056F3: NYHA class over the 2-year study period. At 2 years, 53% of patients were in NYHA class I or II, 19% were in class III and 3% in class IV. BL, baseline; NYHA, New York Heart Association.

Mentions: At 2 years, 37 patients (53%) were in the New York Heart Association (NYHA) class I or II, 13 (19%) in class III and 2 (3%) in class IV (figure 3). Six minutes walking distance improved from 425±104 m at baseline to 523±108 m at 2-year follow-up (p<0.01). Pulmonary artery pressure decreased from 48±16 mm Hg at baseline to 35±11 mm Hg at 2-year follow-up (p<0.01). Left ventricular end-diastolic volume was 161±96 mL at baseline and 137±61 mL at 2-year follow-up (p=0.18). LV-EF remained unchanged. LAVI was 61±26 mL/m2 at baseline and 55±21 mL/m2 at 2-year follow-up (p=0.54).


Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome.

Toggweiler S, Zuber M, Sürder D, Biaggi P, Gstrein C, Moccetti T, Pasotti E, Gaemperli O, Faletra F, Petrova-Slater I, Grünenfelder J, Jamshidi P, Corti R, Pedrazzini G, Lüscher TF, Erne P - Open Heart (2014)

NYHA class over the 2-year study period. At 2 years, 53% of patients were in NYHA class I or II, 19% were in class III and 3% in class IV. BL, baseline; NYHA, New York Heart Association.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4195933&req=5

OPENHRT2014000056F3: NYHA class over the 2-year study period. At 2 years, 53% of patients were in NYHA class I or II, 19% were in class III and 3% in class IV. BL, baseline; NYHA, New York Heart Association.
Mentions: At 2 years, 37 patients (53%) were in the New York Heart Association (NYHA) class I or II, 13 (19%) in class III and 2 (3%) in class IV (figure 3). Six minutes walking distance improved from 425±104 m at baseline to 523±108 m at 2-year follow-up (p<0.01). Pulmonary artery pressure decreased from 48±16 mm Hg at baseline to 35±11 mm Hg at 2-year follow-up (p<0.01). Left ventricular end-diastolic volume was 161±96 mL at baseline and 137±61 mL at 2-year follow-up (p=0.18). LV-EF remained unchanged. LAVI was 61±26 mL/m2 at baseline and 55±21 mL/m2 at 2-year follow-up (p=0.54).

Bottom Line: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year.Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

View Article: PubMed Central - PubMed

Affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland.

ABSTRACT

Objective: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.

Methods: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively.

Results: A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m(2) at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival.

Conclusions: A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m(2), the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

No MeSH data available.


Related in: MedlinePlus