Elevated Mitral Valve Pressure Gradient Is Predictive of Long‐Term Outcome After Percutaneous Edge‐to‐Edge Mitral Valve Repair in Patients With Degenerative Mitral Regurgitation (MR), But Not in Functional MR
| Autor: | Miriam Ulrich, Peter Seizer, Wenzhong Zhang, Fabian Bamberg, Matthias Mezger, Annika Becker, Juergen Schreieck, Johannes Patzelt, Mohammed F. Saad, Tara A.E. Patzelt, Peter Boekstegers, Henry Nording, Reinhard Sauter, Christian Schlensak, Harald F. Langer, Volker Rudolph, Meinrad Gawaz, Ingo Eitel |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
mitral valve
Male Cardiac Catheterization Percutaneous Complications Mitral Valve Annuloplasty medicine.medical_treatment Kaplan-Meier Estimate 030204 cardiovascular system & hematology Severity of Illness Index 0302 clinical medicine Catheter-Based Coronary and Valvular Interventions Mitral valve 030212 general & internal medicine Original Research Aged 80 and over mitral valve regurgitation Mitral Valve Insufficiency Prognosis medicine.anatomical_structure Treatment Outcome Echocardiography Cardiology Female Cardiology and Cardiovascular Medicine Mitral valve regurgitation Percutaneous Mitral Valve Repair mitral stenosis Reoperation medicine.medical_specialty 03 medical and health sciences Internal medicine medicine Pressure Humans In patient percutaneous mitral valve repair Mortality Pressure gradient Aged Proportional Hazards Models Mitral regurgitation Mitral valve repair business.industry percutaneous treatment Hemodynamics medicine.disease Valvular Heart Disease Heart-Assist Devices business |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background This study analyzed the effects on long‐term outcome of residual mitral regurgitation ( MR ) and mean mitral valve pressure gradient ( MVPG ) after percutaneous edge‐to‐edge mitral valve repair using the MitraClip system. Methods and Results Two hundred fifty‐five patients who underwent percutaneous edge‐to‐edge mitral valve repair were analyzed. Kaplan–Meier and Cox regression analyses were performed to evaluate the impact of residual MR and MVPG on clinical outcome. A combined clinical end point (all‐cause mortality, MV surgery, redo procedure, implantation of a left ventricular assist device) was used. After percutaneous edge‐to‐edge mitral valve repair, mean MVPG increased from 1.6±1.0 to 3.1±1.5 mm Hg ( P MR severity to ≤2+ postintervention was achieved in 98.4% of all patients. In the overall patient cohort, residual MR was predictive of the combined end point while elevated MVPG >4.4 mm Hg was not according to Kaplan–Meier and Cox regression analyses. We then analyzed the cohort with degenerative and that with functional MR separately to account for these different entities. In the cohort with degenerative MR , elevated MVPG was associated with increased occurrence of the primary end point, whereas this was not observed in the cohort with functional MR . Conclusions MVPG >4.4 mm Hg after MitraClip implantation was predictive of clinical outcome in the patient cohort with degenerative MR . In the patient cohort with functional MR , MVPG >4.4 mm Hg was not associated with increased clinical events. |
| Databáze: | OpenAIRE |
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