Overall impact of tethering and of its symmetric and asymmetric subtypes on early and long-term outcome of transcatheter edge-to-edge repair of significant mitral valve regurgitation.

Autor: Corcione N; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy., Ferraro P; Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy., Finizio F; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy., Cimmino M; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy., Albanese M; Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy., Morello A; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy., Biondi-Zoccai G; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy. Electronic address: giuseppe.biondizoccai@uniroma1.it., Denti P; Department of Cardiac Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy., Popolo Rubbio A; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Bedogni F; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy., Bartorelli AL; IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy., Mongiardo A; Division of Cardiology, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy., Giordano S; Division of Cardiology, Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy., De Felice F; Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy., Adamo M; Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia, and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia, both in Brescia, Italy., Montorfano M; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy., Maisano F; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy., Tarantini G; Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit, University of Padua, Padua, Italy., Giannini F; Division of Cardiology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy., Ronco F; Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, AULSS3 Serenissima, Mestre, Venezia, Italy., Villa E; Cardiac Surgery Unit and Valve Center, Poliambulanza Foundation Hospital, Brescia, Italy., Ferrario M; Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy., Fiocca L; Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy., Castriota F; Interventional Cardiology Unit, GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy., Squeri A; Interventional Cardiology Unit, GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy., Pepe M; Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari Aldo Moro, Bari, Italy., Tamburino C; Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy., Giordano A; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2024 Dec 09; Vol. 421, pp. 132874. Date of Electronic Publication: 2024 Dec 09.
DOI: 10.1016/j.ijcard.2024.132874
Abstrakt: Background: Tethering is a common condition of the mitral valve apparatus in the presence of significant regurgitation. Its impact on outcomes of transcatheter edge-to-edge repair (TEER) remains poorly characterized.
Methods: We appraised the prevalence, features, procedural details, and outcomes of patients with or without mitral valve tethering in a prospective multicenter observational study. The primary endpoint was the risk of cardiac death or rehospitalization for heart failure at mid-term follow-up.
Results: We included 2238 patients, 1467 (65.5 %) without tethering and 771 (34.5 %) with tethering (487 [21.8 %] with symmetric and 284 [12.7 %] with asymmetric tethering). Several differences in baseline features were evident among groups, yet procedural results were similar. After a median of 14 months, rates of cardiac death or rehospitalization for heart failure was significantly higher at unadjusted analysis in patients with tethering (191 [24.8 %] vs. 272 [18.5 %] in those without tethering, p = 0.001), but weres similar between tethering subtypes (p = 0.666). At adjusted analysis, the presence of any tethering was no longer a significant predictor of cardiac death or rehospitalization for heart failure, and the same results were obtained focusing on tethering subtypes (all p > 0.05).
Conclusions: Tethering is common among patients with an indication to TEER, and is associated with adverse baseline and procedural features. In spite of this, device and procedural success rates are not significantly impacted by the presence of tethering that does not even have a negative prognostic effect at follow-up. Accordingly, tethering should not be considered a contraindication to TEER in suitable patients.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: