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Transseptal and transmitral Parachute® implantation in conjunction with "MitraClipping"

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Transseptal and transmitral Parachute® implantation in conjunction with "MitraClipping". / Schaefer, Ulrich; Lubos, Edith; Deuschl, Florian; Schofer, Niklas; Grahn, Hanno; Conradi, Lenard; Schirmer, Johannes; Reichenspurner, Hermann; Schmidt, Tobias; Frerker, Christian; Kuck, Karl-Heinz; Westermann, Dirk; Blankenberg, Stefan; Treede, Hendrik.

In: EUROINTERVENTION, Vol. 11, No. 6, 10.2015, p. 673-681.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Schaefer, U, Lubos, E, Deuschl, F, Schofer, N, Grahn, H, Conradi, L, Schirmer, J, Reichenspurner, H, Schmidt, T, Frerker, C, Kuck, K-H, Westermann, D, Blankenberg, S & Treede, H 2015, 'Transseptal and transmitral Parachute® implantation in conjunction with "MitraClipping"', EUROINTERVENTION, vol. 11, no. 6, pp. 673-681. https://doi.org/10.4244/EIJY15M09_05

APA

Schaefer, U., Lubos, E., Deuschl, F., Schofer, N., Grahn, H., Conradi, L., Schirmer, J., Reichenspurner, H., Schmidt, T., Frerker, C., Kuck, K-H., Westermann, D., Blankenberg, S., & Treede, H. (2015). Transseptal and transmitral Parachute® implantation in conjunction with "MitraClipping". EUROINTERVENTION, 11(6), 673-681. https://doi.org/10.4244/EIJY15M09_05

Vancouver

Schaefer U, Lubos E, Deuschl F, Schofer N, Grahn H, Conradi L et al. Transseptal and transmitral Parachute® implantation in conjunction with "MitraClipping". EUROINTERVENTION. 2015 Oct;11(6):673-681. https://doi.org/10.4244/EIJY15M09_05

Bibtex

@article{44bfb151876f43449c8d443f71e6c598,
title = "Transseptal and transmitral Parachute{\textregistered} implantation in conjunction with {"}MitraClipping{"}",
abstract = "AIMS: Parachute{\textregistered} implantation (PI) is an attractive treatment option for patients with left ventricular apical aneurysms (LVAA). So far, only the retrograde approach has been approved for PI. Unfortunately, severe functional mitral regurgitation (MR) restricts PI. Thus, we were intrigued to combine PI and MitraClip therapy (MCT) as a new transvenous hybrid concept.METHODS AND RESULTS: PI was performed via a transseptally placed MitraClip guide in six consecutive patients (age 73.8±5.2; 66% male). Immediately after PI, MR was treated by MCT. Invasive right and left heart haemodynamics were taken before and after PI and MCT, respectively. Procedural success was 100%. PI induced a numerical increase in cardiac output (CO: +36.4; p=0.15) and stroke volume (SV: +30.1%; p=0.09), despite some evidence of MR aggravation. Subsequent MCT successfully reduced MR at least to mild in five patients and to moderate in one patient. SV and CO demonstrated a further increase (SV: +44.3%, p=0.03; CO: +44.5%; p=0.03).CONCLUSIONS: The study documents for the first time the feasibility of transseptal and transmitral PI. Nevertheless, pre-procedural MR seems to counteract the beneficial effects of PI. Hence, the combined transseptal approach of PI and MCT seems to be the appropriate strategy in patients with significant MR and LVAA.",
keywords = "Aged, Atrial Function, Left, Cardiac Catheterization/adverse effects, Echocardiography, Doppler, Color, Echocardiography, Transesophageal, Feasibility Studies, Female, Heart Aneurysm/complications, Heart Septum/diagnostic imaging, Hemodynamics, Humans, Male, Mitral Valve/diagnostic imaging, Mitral Valve Insufficiency/complications, Prosthesis Design, Prosthesis Implantation/adverse effects, Punctures, Radiography, Treatment Outcome, Ventricular Function, Left",
author = "Ulrich Schaefer and Edith Lubos and Florian Deuschl and Niklas Schofer and Hanno Grahn and Lenard Conradi and Johannes Schirmer and Hermann Reichenspurner and Tobias Schmidt and Christian Frerker and Karl-Heinz Kuck and Dirk Westermann and Stefan Blankenberg and Hendrik Treede",
year = "2015",
month = oct,
doi = "10.4244/EIJY15M09_05",
language = "English",
volume = "11",
pages = "673--681",
journal = "EUROINTERVENTION",
issn = "1774-024X",
publisher = "EUROPA EDITION",
number = "6",

}

RIS

TY - JOUR

T1 - Transseptal and transmitral Parachute® implantation in conjunction with "MitraClipping"

AU - Schaefer, Ulrich

AU - Lubos, Edith

AU - Deuschl, Florian

AU - Schofer, Niklas

AU - Grahn, Hanno

AU - Conradi, Lenard

AU - Schirmer, Johannes

AU - Reichenspurner, Hermann

AU - Schmidt, Tobias

AU - Frerker, Christian

AU - Kuck, Karl-Heinz

AU - Westermann, Dirk

AU - Blankenberg, Stefan

AU - Treede, Hendrik

PY - 2015/10

Y1 - 2015/10

N2 - AIMS: Parachute® implantation (PI) is an attractive treatment option for patients with left ventricular apical aneurysms (LVAA). So far, only the retrograde approach has been approved for PI. Unfortunately, severe functional mitral regurgitation (MR) restricts PI. Thus, we were intrigued to combine PI and MitraClip therapy (MCT) as a new transvenous hybrid concept.METHODS AND RESULTS: PI was performed via a transseptally placed MitraClip guide in six consecutive patients (age 73.8±5.2; 66% male). Immediately after PI, MR was treated by MCT. Invasive right and left heart haemodynamics were taken before and after PI and MCT, respectively. Procedural success was 100%. PI induced a numerical increase in cardiac output (CO: +36.4; p=0.15) and stroke volume (SV: +30.1%; p=0.09), despite some evidence of MR aggravation. Subsequent MCT successfully reduced MR at least to mild in five patients and to moderate in one patient. SV and CO demonstrated a further increase (SV: +44.3%, p=0.03; CO: +44.5%; p=0.03).CONCLUSIONS: The study documents for the first time the feasibility of transseptal and transmitral PI. Nevertheless, pre-procedural MR seems to counteract the beneficial effects of PI. Hence, the combined transseptal approach of PI and MCT seems to be the appropriate strategy in patients with significant MR and LVAA.

AB - AIMS: Parachute® implantation (PI) is an attractive treatment option for patients with left ventricular apical aneurysms (LVAA). So far, only the retrograde approach has been approved for PI. Unfortunately, severe functional mitral regurgitation (MR) restricts PI. Thus, we were intrigued to combine PI and MitraClip therapy (MCT) as a new transvenous hybrid concept.METHODS AND RESULTS: PI was performed via a transseptally placed MitraClip guide in six consecutive patients (age 73.8±5.2; 66% male). Immediately after PI, MR was treated by MCT. Invasive right and left heart haemodynamics were taken before and after PI and MCT, respectively. Procedural success was 100%. PI induced a numerical increase in cardiac output (CO: +36.4; p=0.15) and stroke volume (SV: +30.1%; p=0.09), despite some evidence of MR aggravation. Subsequent MCT successfully reduced MR at least to mild in five patients and to moderate in one patient. SV and CO demonstrated a further increase (SV: +44.3%, p=0.03; CO: +44.5%; p=0.03).CONCLUSIONS: The study documents for the first time the feasibility of transseptal and transmitral PI. Nevertheless, pre-procedural MR seems to counteract the beneficial effects of PI. Hence, the combined transseptal approach of PI and MCT seems to be the appropriate strategy in patients with significant MR and LVAA.

KW - Aged

KW - Atrial Function, Left

KW - Cardiac Catheterization/adverse effects

KW - Echocardiography, Doppler, Color

KW - Echocardiography, Transesophageal

KW - Feasibility Studies

KW - Female

KW - Heart Aneurysm/complications

KW - Heart Septum/diagnostic imaging

KW - Hemodynamics

KW - Humans

KW - Male

KW - Mitral Valve/diagnostic imaging

KW - Mitral Valve Insufficiency/complications

KW - Prosthesis Design

KW - Prosthesis Implantation/adverse effects

KW - Punctures

KW - Radiography

KW - Treatment Outcome

KW - Ventricular Function, Left

U2 - 10.4244/EIJY15M09_05

DO - 10.4244/EIJY15M09_05

M3 - SCORING: Journal article

C2 - 26348676

VL - 11

SP - 673

EP - 681

JO - EUROINTERVENTION

JF - EUROINTERVENTION

SN - 1774-024X

IS - 6

ER -