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Article: Real-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation - Compromise Between Mitral Regurgitation Reduction and Maintenance of Adequate Opening Area -

TitleReal-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation - Compromise Between Mitral Regurgitation Reduction and Maintenance of Adequate Opening Area -
Authors
Issue Date2012
Citation
Circulation Journal, 2012, v. 76 n. 10, p. 2488-2493 How to Cite?
AbstractBackground: Percutaneous edge-to-edge mitral valve repair with the MitraClip® was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. Herein is reported our experience on MitraClip® for high-risk surgical candidates with severe mitral regurgitation (MR). Methods and Results: Patients with severe MR (3 or 4+) and high operative risk were considered for MitraClip® implantation. Device success was defined as placement of 1 or more MitraClips® with reduction of MR to ≤2+. Patients were followed up clinically and with echocardiography at 1 year. A total of 27 patients with severe MR (age, 74±12 years; 17 male; logistic EuroSCORE, 27±12; left ventricular ejection fraction, 40±17%) were treated. Fifty-six percent of MR was degenerative and 44% was functional. Device success was 93% with 14 patients receiving 2 clips. MR severity was reduced from 3.5±0.5 to 1.7±0.8 (P<0.001); New York Heart Association class improved from 3.1±0.4 to 2.0±0.8 (P<0.001). In 45% of functional and in 29% of degenerative MR patients, to avoid mitral stenosis, additional MitraClip® implantation was not attempted, with resultant transmitral mean gradient of 4.9±1.6 mmHg vs. 3.1±1.4 mmHg, respectively (P=0.01). Conclusions: MitraClip® was shown to be an effective and safe treatment for patients with both functional and degenerative MR. Inability to obtain a greater reduction of MR was the consequence of borderline transmitral gradient requiring a compromise to avoid mitral stenosis, particularly in the functional MR patients.
Persistent Identifierhttp://hdl.handle.net/10722/194467
ISSN
2015 Impact Factor: 4.124
2015 SCImago Journal Rankings: 1.728
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, PH-
dc.contributor.authorShe, HL-
dc.contributor.authorAlegria-Barrero, E-
dc.contributor.authorMoat, N-
dc.contributor.authordi Mario, C-
dc.contributor.authorFranzen, O-
dc.date.accessioned2014-01-30T03:32:37Z-
dc.date.available2014-01-30T03:32:37Z-
dc.date.issued2012-
dc.identifier.citationCirculation Journal, 2012, v. 76 n. 10, p. 2488-2493-
dc.identifier.issn1346-9843-
dc.identifier.urihttp://hdl.handle.net/10722/194467-
dc.description.abstractBackground: Percutaneous edge-to-edge mitral valve repair with the MitraClip® was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. Herein is reported our experience on MitraClip® for high-risk surgical candidates with severe mitral regurgitation (MR). Methods and Results: Patients with severe MR (3 or 4+) and high operative risk were considered for MitraClip® implantation. Device success was defined as placement of 1 or more MitraClips® with reduction of MR to ≤2+. Patients were followed up clinically and with echocardiography at 1 year. A total of 27 patients with severe MR (age, 74±12 years; 17 male; logistic EuroSCORE, 27±12; left ventricular ejection fraction, 40±17%) were treated. Fifty-six percent of MR was degenerative and 44% was functional. Device success was 93% with 14 patients receiving 2 clips. MR severity was reduced from 3.5±0.5 to 1.7±0.8 (P<0.001); New York Heart Association class improved from 3.1±0.4 to 2.0±0.8 (P<0.001). In 45% of functional and in 29% of degenerative MR patients, to avoid mitral stenosis, additional MitraClip® implantation was not attempted, with resultant transmitral mean gradient of 4.9±1.6 mmHg vs. 3.1±1.4 mmHg, respectively (P=0.01). Conclusions: MitraClip® was shown to be an effective and safe treatment for patients with both functional and degenerative MR. Inability to obtain a greater reduction of MR was the consequence of borderline transmitral gradient requiring a compromise to avoid mitral stenosis, particularly in the functional MR patients.-
dc.languageeng-
dc.relation.ispartofCirculation Journal-
dc.titleReal-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation - Compromise Between Mitral Regurgitation Reduction and Maintenance of Adequate Opening Area --
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1253/circj.CJ-12-0379-
dc.identifier.pmid22785461-
dc.identifier.scopuseid_2-s2.0-84867860333-
dc.identifier.volume76-
dc.identifier.issue10-
dc.identifier.spage2488-
dc.identifier.epage2493-
dc.identifier.isiWOS:000309331400029-

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