We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
In-Hospital Outcome of Patients with Severe Mitral Valve Regurgitation Classified as Inoperable and Treated with the MitraClip(R) Device.
- Authors
Divchev D; Kische S; Paranskaya L; Schneider H; Rehders T; Ortak J; Akin I; Turan G; Turan CH; Steinhoff G; Nöldge-Schomburg G; Nienaber CA; Ince H
- Abstract
Background: To evaluate the short-term outcome of patients predominantly at high risk treated with the MitraClip(R) device for severe mitral valve regurgitation (MR) using one or more clips. Methods: We prospectively analyzed patients with highly symptomatic MR classified as inoperable (logistic EuroSCORE 24.16 ± 13.64%; STS-score 29.9 ± 14.5%) but subject to mitral valve repair with MitraClip(R) between May 2010 and January 2011. Thirty-three consecutive patients (57.6% male; age 77.8 ± 6.7 years) were enrolled and treated with either 1 (n = 7; 21.2%), 2 (n = 20; 60.6%), 3 (n = 4; 12.1%), or 4 (n = 2, 6.1%) clips. Grading of MR was performed by two-dimensional transesophageal echocardiography (2D-TEE) prior to TEE-guided clipping and before discharge. Results: MR was classified as functional in 23 (69.7%) and organic in 10 (30.3%) of the patients with MR-grade >= 3+ in 32 (97%) and = 4 in 1 patients (3%) before repair. Reduction in MR grade to grade <=1+ was achieved in 81.7% and to 2 in 12.1% (P = 0.00072). Invasive pulmonary artery systolic pressure (PAPsyst) and pulmonary capillary wedge pressure (PCWP) v-wave decreased from 59.2 ± 18.6 to 46.9 ± 15.3 mmHg (P = 0.00014) and 21.2 ± 6.7 to 8.0 ± 3.3 mmHg (P = 0.0093), respectively, as measured immediately after clipping. Functional NYHA class improved from mean 3 (range 3 [90.9%] to 4 [9.1%]) to 2 in 84.9% (P = 0.00081) as obtained at discharge. Conclusions: Mitral valve repair with MitraClip(R) using multiple clips is appropriate and safe in unselected patients resulting in reduced MR with positive impact on short-term functional capacity. (J Interven Cardiol 2012;25:180-189).
- Publication
Journal of Interventional Cardiology, 2012, Vol 25, Issue 2, p180
- ISSN
0896-4327
- Publication type
Journal Article
- DOI
10.1111/j.1540-8183.2011.00688.x