Comparison of Outcome After Percutaneous Mitral Valve Repair With the MitraClip in Patients With Versus Without Atrial Fibrillation

Autor: Marije M. Vis, Jan Van der Heyden, Ad J. van Boven, Jeroen Schaap, Berto J. Bouma, Friso Kortlandt, Jan J. Piek, Jan Baan, Tom Hendriks, Benno J. Rensing, José P.S. Henriques, Karel T. Koch, Remco A. J. Schurer, Juliëtte F. Velu, Ben J L Van den Branden, Martin J. Swaans
Přispěvatelé: Cardiology, Graduate School, ACS - Amsterdam Cardiovascular Sciences, APH - Aging & Later Life, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation
Rok vydání: 2017
Předmět:
Male
IMPACT
Kaplan-Meier Estimate
DETERMINANTS
REGURGITATION
030204 cardiovascular system & hematology
Severity of Illness Index
Ventricular Function
Left
DISEASE
Coronary artery disease
Electrocardiography
Postoperative Complications
0302 clinical medicine
Mitral valve
Atrial Fibrillation
030212 general & internal medicine
Netherlands
Aged
80 and over
Heart Valve Prosthesis Implantation
RISK
medicine.diagnostic_test
Incidence
MitraClip
Mitral Valve Insufficiency
Atrial fibrillation
Middle Aged
Treatment Outcome
medicine.anatomical_structure
FUNCTIONAL STATUS
Heart Valve Prosthesis
Cardiology
Mitral Valve
Female
Cardiology and Cardiovascular Medicine
Percutaneous Mitral Valve Repair
medicine.medical_specialty
RHYTHM MANAGEMENT
Prosthesis Design
03 medical and health sciences
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Mitral regurgitation
business.industry
MORTALITY
Retrospective cohort study
medicine.disease
Surgery
FOLLOW-UP
business
Echocardiography
Transesophageal
TO-EDGE REPAIR
Zdroj: American journal of cardiology, 120(11), 2035-2040. Elsevier Inc.
American Journal of Cardiology, 120(11), 2035-2040. EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
ISSN: 0002-9149
Popis: Percutaneous mitral valve repair with the MitraClip is an established treatment for patients with mitral regurgitation (MR) who are inoperable or at high risk for surgery. Atrial Fibrillation (AF) frequently coincides with MR, but only scarce data of the influence of AF on outcome after MitraClip is available. The aim of the current study was to compare the clinical outcome after MitraClip treatment in patients with versus without atrial fibrillation. Between January 2009 and January 2016, all consecutive patients treated with a MitraClip in 5 Dutch centers were included. Outcome measures were survival, symptoms, MR grade, and stroke incidence. In total, 618 patients were treated with a MitraClip. Patients with AF were older, had higher N-terminal B-type natriuretic peptide levels, more tricuspid regurgitation, less often coronary artery disease and a better left ventricular function. Survival of patients treated with the MitraClip was similar for patients with AF (82%) and without AF (non-AF; 85%) after 1 year (p = 0.30), but significantly different after 5-year follow-up (AF 34%; non-AF 47%; p = 0.006). After 1 month, 64% of the patients with AF were in New York Heart Association class I or II, in contrast to 77% of the patients without AF (p = 0.001). The stroke incidence appeared not to be significantly different (AF 1.8%; non-AF 1.0%; p = 0.40). In conclusion, patients with AF had similar 1-year survival, MR reduction, and stroke incidence compared with non-AF patients. However, MitraClip patients with AF had reduced long-term survival and remained more symptomatic compared with those without AF. (C) 2017 Elsevier Inc. All rights reserved
Databáze: OpenAIRE
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