Echocardiographic Predictors of Suboptimal Transcatheter Mitral Valve Repair in Patients With Secondary Mitral Regurgitation.

Autor:	Labin JE; Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Tehrani DM; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Lai P; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Yang EH; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Lluri G; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Nsair A; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Aksoy O; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Parikh RV; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Rafique AM; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California., Calfon Press M; Division of Cardiology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	Journal of the Society for Cardiovascular Angiography & Interventions [J Soc Cardiovasc Angiogr Interv] 2022 Sep 29; Vol. 1 (6), pp. 100495. Date of Electronic Publication: 2022 Sep 29 (Print Publication: 2022).
DOI:	10.1016/j.jscai.2022.100495
Abstrakt:	Background: Residual mitral regurgitation (MR) following mitral valve transcatheter edge-to-edge repair (TEER) is associated with worse outcomes. This study sought to identify echocardiographic predictors of suboptimal residual MR after TEER in patients with secondary MR. Methods: In this retrospective single-center study, we identified all patients with secondary MR who underwent TEER between 2016 and 2021. Pre- and intraprocedural transesophageal echocardiographic images were reviewed. The primary outcome was suboptimal residual MR, defined as ≥2+ residual MR on postprocedural transesophageal echocardiography. The association of preprocedural echocardiographic parameters with the primary outcome was tested via logistic regression. Results: Sixty-five patients (69 ± 15 years; 49% women) with secondary MR underwent TEER with MitraClip. All patients had moderate-severe or severe (3-4+) MR preoperatively, with an average left ventricular ejection fraction of 35% and New York Heart Association class III symptoms. Procedural success, defined as ≤2+ MR post-TEER, was achieved in 94%. A suboptimal residual MR was observed in 38%. Independent predictors of suboptimal residual MR included bicommissural MR (odds ratio [OR], 7.95; 95% CI, 1.50-42.3; P = .02), 2-dimensional anteroposterior diameter (OR, 6.46; 95% CI, 1.85-22.51 per cm; P < .01), and mitral valve area to left ventricular end-diastolic volume ratio (OR, 0.69; 95% CI, 0.50-0.93 per mm 2 /mL; P = .02). Conclusions: Certain echocardiographic features, including bicommissural MR, a larger annular diameter, and a smaller ratio of mitral valve area to left ventricular end-diastolic volume, are associated with suboptimal residual MR following TEER. These preprocedural measurements may optimize patient selection in those with secondary MR being considered for TEER. (© 2022 The Authors.)
Databáze:	MEDLINE
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