Outcomes of urgent/emergent transcatheter mitral valve repair (MitraClip): A single center experience
| Autor: | Creighton W. Don, Sean Bell, Mark Reisman, Christopher P. Kovach, Akash Kataruka |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Cardiac Catheterization Acute decompensated heart failure medicine.medical_treatment 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Prospective cohort study Retrospective Studies Mechanical ventilation Heart Valve Prosthesis Implantation Mitral regurgitation Mitral valve repair business.industry Cardiogenic shock MitraClip Mitral Valve Insufficiency General Medicine medicine.disease Treatment Outcome Respiratory failure Emergency medicine Mitral Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventionsREFERENCES. 97(3) |
| ISSN: | 1522-726X |
| Popis: | Objectives To describe the outcomes of urgent/emergent transcatheter edge-to-edge mitral valve repair (TMVr) and compare the clinical, echocardiographic, and procedural characteristics of survivors and nonsurvivors. Background TMVr is a treatment strategy for select patients with severe primary or secondary mitral regurgitation. However, knowledge regarding outcomes for urgent/emergent TMVr is limited. Methods All urgent or emergent TMVr procedures using MitraClip performed at the University of Washington Medical Center between January 2018 and March 2019 were identified and clinical, echocardiographic, hemodynamic, procedural, and outcomes data were obtained by chart review. Outcomes included all-cause mortality, hospital mortality, procedural success, periprocedural complications, and hospital readmission. Results Of the 20 patients who underwent urgent/emergent TMVr, eight were treated for cardiogenic shock (CS), four for acute decompensated heart failure (ADHF) with hypoxemic respiratory failure requiring mechanical ventilation, and eight for ADHF with failure of inpatient medical therapy. Mechanical circulatory support (MCS) was used in six patients; preceding TMVr in three patients and immediately post-TMVr in three patients. Overall, 30-day mortality and hospital readmission rates were 21 and 13%, respectively. Over a median 153 days (IQR 20-491) of follow-up, 10 patients (50%) died. Preprocedure CS, new or ongoing MCS post-TMVr, refractory respiratory failure post-TMVr, and acute kidney injury post-TMVr were associated with mortality. Conclusions In a single-center retrospective analysis, urgent/emergent TMVr in high-risk patients with ADHF or CS was associated with high short-term mortality and periprocedural complications. Prospective studies are warranted to inform patient selection and periprocedural management for urgent/emergent TMVr. |
| Databáze: | OpenAIRE |
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