Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction
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Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction. / Franzen, Olaf; Baldus, Stephan; Rudolph, Volker; Meyer, Sven; Knap, Malgorzata; Koschyk, Dietmar; Treede, Hendrik; Barmeyer, Achim; Schofer, Joachim; Costard-Jäckle, Angelika; Schlüter, Michael; Reichenspurner, Hermann; Meinertz, Thomas.
in: EUR HEART J, Jahrgang 31, Nr. 11, 06.2010, S. 1373-1381.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction
AU - Franzen, Olaf
AU - Baldus, Stephan
AU - Rudolph, Volker
AU - Meyer, Sven
AU - Knap, Malgorzata
AU - Koschyk, Dietmar
AU - Treede, Hendrik
AU - Barmeyer, Achim
AU - Schofer, Joachim
AU - Costard-Jäckle, Angelika
AU - Schlüter, Michael
AU - Reichenspurner, Hermann
AU - Meinertz, Thomas
PY - 2010/6
Y1 - 2010/6
N2 - AIMS: We sought to assess the feasibility of catheter-based mitral valve repair using the MitraClip system in high-surgical-risk patients with mitral regurgitation (MR) > or =grade 3+.METHODS AND RESULTS: MitraClip therapy was performed in 51 consecutive patients [73 +/- 10 years; 34 (67%) men] with symptomatic functional [n = 35 (69%)] or organic MR [n = 16 (31%)]. Mean logistic EuroSCORE was 29 +/- 22%; Society of Thoracic Surgeons score was 15 +/- 11. Left ventricular (LV) ejection fraction was 36 +/- 17%. In 35 patients (69%), adverse mitral valve morphology and/or severe LV dysfunction were present. MitraClip implantation was successful in 49 patients (96%). Most patients [n = 34/49 (69%)] were treated with a single clip, whereas 14 patients (29%) received two clips and one patient received three clips. Mean device and fluoroscopy times were 105 +/- 65 min and 44 +/- 28 min, respectively. Procedure-related reduction in MR severity was one grade in 16 patients (31%), two grades in 24 patients (47%), and three grades in 9 patients (18%). Forty-four of the 49 successfully treated patients (90%) showed clinical improvement at discharge [NYHA functional class > or =III in 48 patients (98%) before and 16 patients (33%) after the procedure (P < 0.0001)]. There were no procedure-related major adverse events and no in-hospital mortality.CONCLUSION: Mitral valve repair using the MitraClip system was shown to be feasible in patients at high surgical risk primarily determined by an adverse mitral valve morphology and/or severe LV dysfunction.
AB - AIMS: We sought to assess the feasibility of catheter-based mitral valve repair using the MitraClip system in high-surgical-risk patients with mitral regurgitation (MR) > or =grade 3+.METHODS AND RESULTS: MitraClip therapy was performed in 51 consecutive patients [73 +/- 10 years; 34 (67%) men] with symptomatic functional [n = 35 (69%)] or organic MR [n = 16 (31%)]. Mean logistic EuroSCORE was 29 +/- 22%; Society of Thoracic Surgeons score was 15 +/- 11. Left ventricular (LV) ejection fraction was 36 +/- 17%. In 35 patients (69%), adverse mitral valve morphology and/or severe LV dysfunction were present. MitraClip implantation was successful in 49 patients (96%). Most patients [n = 34/49 (69%)] were treated with a single clip, whereas 14 patients (29%) received two clips and one patient received three clips. Mean device and fluoroscopy times were 105 +/- 65 min and 44 +/- 28 min, respectively. Procedure-related reduction in MR severity was one grade in 16 patients (31%), two grades in 24 patients (47%), and three grades in 9 patients (18%). Forty-four of the 49 successfully treated patients (90%) showed clinical improvement at discharge [NYHA functional class > or =III in 48 patients (98%) before and 16 patients (33%) after the procedure (P < 0.0001)]. There were no procedure-related major adverse events and no in-hospital mortality.CONCLUSION: Mitral valve repair using the MitraClip system was shown to be feasible in patients at high surgical risk primarily determined by an adverse mitral valve morphology and/or severe LV dysfunction.
KW - Aged
KW - Aged, 80 and over
KW - Echocardiography, Doppler, Color
KW - Echocardiography, Transesophageal
KW - Feasibility Studies
KW - Female
KW - Hospitalization
KW - Humans
KW - Male
KW - Middle Aged
KW - Mitral Valve/pathology
KW - Mitral Valve Annuloplasty/instrumentation
KW - Mitral Valve Insufficiency/pathology
KW - Postoperative Complications/etiology
KW - Risk Factors
KW - Surgical Instruments
KW - Ventricular Dysfunction, Left/pathology
U2 - 10.1093/eurheartj/ehq050
DO - 10.1093/eurheartj/ehq050
M3 - SCORING: Journal article
C2 - 20219746
VL - 31
SP - 1373
EP - 1381
JO - EUR HEART J
JF - EUR HEART J
SN - 0195-668X
IS - 11
ER -