Percutaneous valve repair of functional mitral regurgitation: aiming at optimal and durable results

2020 ◽  
Vol 22 (10) ◽  
pp. 1849-1851 ◽  
Author(s):  
Marianna Adamo ◽  
Marco Metra ◽  
Ottavio Alfieri
Keyword(s):  
Mitral Regurgitation ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
Percutaneous Valve Repair ◽  
Percutaneous Valve

scholarly journals Functional mitral regurgitation: structural modifications with percutaneous valve repair with MitraClip

2020 ◽  
Vol 8 (15) ◽  
pp. 958-958
Author(s):  
Alberto Alperi ◽  
Pablo Avanzas ◽  
Isaac Pascual ◽  
Antonio Adeba ◽  
Rebeca Lorca ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
Structural Modifications ◽  
Percutaneous Valve Repair ◽  
Percutaneous Valve

scholarly journals Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Polimeni
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Primary Endpoint ◽  
Cardiovascular Death ◽  
Volume Index ◽  
Valve Repair ◽  
Percutaneous Valve Repair ◽  
Percutaneous Valve

Abstract Background Percutaneous mitral valve repairs has been increasingly performed worldwide. The MITRA-UMG registry provides a snapshot of a real-world clinical data and outcomes. Purpose We sought to investigate predictors of clinical outcomes in patients with mitral regurgitation undergoing percutaneous valve repair. Methods The MITRA-UMG registry retrospectively collected data from consecutive patients with symptomatic moderate-to-severe or severe MR underwent MitraClip implantation. The primary endpoint of interest was the composite of cardiovascular death or rehospitalization for HF. Results Between March 2012 and July 2018, a total of 133 consecutive patients admitted to our institution were included. Acute procedural success was obtained in 95.4% of patients, with no intraprocedural death. The composite primary endpoint of cardiovascular death or rehospitalization for heart failure was met in 50 patients (38%) with cumulative incidences of 7%, 25%, at 30 days and 1 year, respectively. In the Cox multivariate model, NYHA functional class IV, left ventricular end-diastolic volume index (LVEDVi), Euroscore II, independently increased the risk of the primary endpoint at long-term follow-up. At Kaplan-Meier analysis, a LVEDVi >92 ml/m2 was associated with an increased incidence of the primary endpoint. Conclusions In searching the ideal phenotype of patients who benefit most of percutaneous mitral valve repair, those presenting with severely dilated ventricles (LVEDVi >92 ml/m2), high operative risk (EUROSCORE II >7%) or advanced heart failure symptoms (NYHA IV) at baseline carried the worst prognosis at long-term. Funding Acknowledgement Type of funding source: None

scholarly journals Predictors of outcomes in patients with mitral regurgitation undergoing percutaneous valve repair

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Alberto Polimeni ◽  
Michele Albanese ◽  
Nadia Salerno ◽  
Iolanda Aquila ◽  
Jolanda Sabatino ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Primary Endpoint ◽  
Cardiovascular Death ◽  
Valve Repair ◽  
Percutaneous Mitral Valve Repair ◽  
Percutaneous Valve Repair ◽  
Percutaneous Valve

Abstract Percutaneous mitral valve repair has been increasingly performed worldwide after approval. We sought to investigate predictors of clinical outcome in patients with mitral regurgitation undergoing percutaneous valve repair. The MITRA-UMG study, a single-centre registry, retrospectively collected consecutive patients with symptomatic moderate-to-severe or severe MR undergoing MitraClip therapy. The primary endpoint was the composite of cardiovascular death or rehospitalization for heart failure. Between March 2012 and July 2018, a total of 150 consecutive patients admitted to our institution were included. Procedural success was obtained in 95.3% of patients. The composite primary endpoint of cardiovascular death or rehospitalization for HF was met in 55 patients (37.9%) with cumulative incidences of 7.6%, 26.2%, at 30 days and 1-year, respectively. In the Cox multivariate model, NYHA functional class and left ventricular end-diastolic volume index (LVEDVi), independently increased the risk of the primary endpoint at long-term follow-up. At Kaplan–Meier analysis, a LVEDVi > 92 ml/m2 was associated with an increased incidence of the primary endpoint. In this study, patients presenting with dilated ventricles (LVEDVi > 92 ml/m2) and advanced heart failure symptoms (NYHA IV) at baseline carried the worst prognosis after percutaneous mitral valve repair.

Mechanism and Severity of Mitral Regurgitation by Transesophageal Echocardiography in Patients Referred for Percutaneous Valve Repair

2011 ◽  
Vol 108 (6) ◽  
pp. 882-887 ◽  
Author(s):  
Paul A. Grayburn ◽  
Bradley J. Roberts ◽  
Susan Aston ◽  
Azam Anwar ◽  
Robert F. Hebeler ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Transesophageal Echocardiography ◽  
Valve Repair ◽  
Percutaneous Valve Repair ◽  
Percutaneous Valve

scholarly journals Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Benito Gonzalez ◽  
X Freixa ◽  
C Godino ◽  
M Taramasso ◽  
R Estevez-Loureiro ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
One Year ◽  
The Impact

Abstract Background Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. Methods We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction, functional mitral regurgitation grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Results 93 patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-months follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0–17.8 vs 2.7–13.5, p=0.002), sustained VT or ventricular fibrillation (0.9–2.5 vs 0.5–2.9, p=0.012) and ICD antitachycardia therapies (2.5–12.0 vs 0.9–5.0, p=0.033) were observed. Conclusion PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort. Proportion of patients who presented ven Funding Acknowledgement Type of funding source: None

Percutaneous Mitral Valve Repair Vs. Stand-Alone Medical Therapy in Patients with Functional Mitral Regurgitation and Heart Failure

2020 ◽  
Vol 21 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Tomás Benito-González ◽  
Rodrigo Estévez-Loureiro ◽  
Pedro A. Villablanca ◽  
Patrizio Armeni ◽  
Ignacio Iglesias-Gárriz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Medical Therapy ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
Percutaneous Mitral Valve Repair
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