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- Title
New Echocardiographic Parameters Predicting Successful Trans-Ventricular Beating-Heart Mitral Valve Repair with Neochordae at 3 Years: Monocentric Retrospective Study.
- Authors
Vairo, Alessandro; Gaiero, Lorenzo; Marro, Matteo; Russo, Caterina; Bolognesi, Marco; Soro, Paolo; Gallone, Guglielmo; Fioravanti, Francesco; Desalvo, Paolo; D'Ascenzo, Fabrizio; Alunni, Gianluca; Sebastiano, Viviana; Barbero, Cristina; Pocar, Marco; De Ferrari, Gaetano Maria; Rinaldi, Mauro; Salizzoni, Stefano
- Abstract
The NeoChord procedure is an echo-guided trans-ventricular beating-heart mitral valve repair technique to treat degenerative mitral regurgitation (MR) due to prolapse and/or flail. The aim of this study is to analyze echocardiographic images to find pre-operative parameters to predict procedural success (≤moderate MR) at 3-year follow-up. Seventy-two consecutive patients with severe MR underwent the NeoChord procedure between 2015 and 2021. MV pre-operative morphological parameters were assessed using 3D transesophageal echocardiography with dedicated software (QLAB, Philips). Three patients died during their hospitalization. The remaining 69 patients were retrospectively analyzed. At follow-up, MR > moderate was found in 17 patients (24.6%). In the univariate analysis, end-systolic annulus area (12.5 ± 2.5 vs. 14.1 ± 2.6 cm2; p = 0.038), end-systolic annulus circumference (13.2 ± 1.2 vs. 14 ± 1.3 cm; p = 0.042), indexed left atrial volume (59 ± 17 vs. 76 ± 7 mL/m2; p = 0.041), and AF (25% vs. 53%; p = 0.042) were lower in the 52 patients with ≤ MR compared to those with > moderate MR. Annular dysfunction parameters were the best predictors of procedural success: 3D early-systolic annulus area (AUC 0.74; p = 0.004), 3D early-systolic annulus circumference (AUC 0.75; p = 0.003), and 3D annulus area fractional change (AUC 0.73; p = 0.035). Patient selection relying on 3D dynamic and static MA dimensions may improve the maintenance of procedural success at follow-up.
- Subjects
TRANSESOPHAGEAL echocardiography; MITRAL valve; ECHOCARDIOGRAPHY; MITRAL valve insufficiency; LEFT heart atrium; PATIENT selection
- Publication
Journal of Clinical Medicine, 2023, Vol 12, Issue 5, p1748
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm12051748