Clinical and Echocardiographic Outcomes of Patients Undergoing Transcatheter Edge-to-Edge Repair for Functional vs Degenerative Mitral Valve Regurgitation.

Autor: Dokollari A; Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA; Department of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA; Department of Cardiac Surgery, St. Boniface Hospital, University of Manitoba, Winnipeg, MB. Electronic address: aleksanderdokollari2@gmail.com., Sicouri S; Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA., Ridwan K; Department of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA., Rodriguez R; Department of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA., Gnall E; Department of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA., Harish J; Cardiac Surgery Department, St. Michael's Hospital, University of Toronto, Toronto, ON., Shah A; Department of Cardiac Surgery, St. Boniface Hospital, University of Manitoba, Winnipeg, MB., Ghorpade N; Department of Cardiac Surgery, St. Boniface Hospital, University of Manitoba, Winnipeg, MB., Bisleri G; Cardiac Surgery Department, St. Michael's Hospital, University of Toronto, Toronto, ON., Kjelstrom S; Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA., Montone G; Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA., Abramson S; Division of Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, PA., Hawthorne K; Division of Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, PA., Goldman S; Department of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA., Gray W; Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA; Division of Cardiology, Lankenau Heart Institute, Main Line Health, Wynnewood, PA., Ramlawi B; Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Main Line Health, Wynnewood, PA; Department of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA.
Jazyk: angličtina
Zdroj: Current problems in cardiology [Curr Probl Cardiol] 2024 Jan; Vol. 49 (1 Pt B), pp. 102064. Date of Electronic Publication: 2023 Aug 30.
DOI: 10.1016/j.cpcardiol.2023.102064
Abstrakt: To analyze clinical and echocardiographic outcomes after transcatheter edge-to-edge repair (TEER) with mitral valve clip device (MitraClip-TM) for functional vs degenerative mitral valve regurgitation (MR). All consecutive 185 patients undergoing TEER between January 2019 and March 2023 were included in the study. A propensity-adjusted analysis investigated differences among functional vs degenerative MR mechanism groups. Preoperatively, functional vs degenerative MR included 43 vs 142 patients, respectively. Mean ejection fraction (EF) values were 37% vs 57.8%, mean STS-PROM risk score was 7% vs 4% while patients with severe MR included 29 (67.4%) vs 129 (90.9%) patients, respectively. Postoperatively, functional MR patients experienced a higher incidence of prolonged postoperative length of stay (LOS), reduced creatinine clearance, and EF<50% compared to the degenerative MR group. Mean EF was 35.9% vs 56.2% (P < 0.0001) and 1 (2.3%) vs 16 (11.3%) patients had residual severe MR (P = 0.01) in functional vs degenerative MR groups, respectively. At 30-days follow-up, all-cause death incidence was 1 (2.3%) vs 3 (2.1%) patients in functional vs degenerative MR, respectively (P = 0.9). At a mean of 1.6-years follow-up, all-cause death (P = 0.01), major adverse cardiovascular and cerebrovascular events (MACCE) (P = 0.02), cardiac death (P = 0.01) and hazard ratio for all-cause death higher in functional vs degenerative MR group. Mean EF was 39.7% vs 56% (P < 0.001) while residual severe MR was 4 (9.3%) vs 34 (24.5%) (P = 0.1) in functional vs degenerative MR groups, respectively. TEER with MitraClip device showed a higher incidence of all-cause death, cardiac death, and MACCE at follow-up for functional compared to degenerative MR after TEER.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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