Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR
© 2023 The Author(s)..
Background: Percutaneous mitral valve repair (PMVR) has evolved to be a standard procedure in suitable patients with mitral regurgitation (MR) not accessible for open surgery. Here, we analyzed the influence of the number and positioning of the clips implanted during the procedure on MR reduction analyzing also sub-collectives of functional and degenerative MR (DMR).
Results: We included 410 patients with severe MR undergoing PMVR using the MitraClip® System. MR and reduction of MR were analyzed by TEE at the beginning and at the end of the PMVR procedure. To specify the clip localization, we sub-divided segment 2 into 3 sub-segments using the segmental classification of the mitral valve.
Results: We found an enhanced reduction of MR predominantly in DMR patients who received more than one clip. Implantation of only one clip led to a higher MR reduction in patients with functional MR (FMR) in comparison to patients with DMR. No significant differences concerning pressure gradients could be observed in degenerative MR patients regardless of the number of clips implanted. A deterioration of half a grade of the achieved MR reduction was observed 6 months post-PMVR independent of the number of implanted clips with a better stability in FMR patients, who got 3 clips compared to patients with only one clip.
Conclusions: In patients with FMR, after 6 months the reduction of MR was more stable with an increased number of implanted clips, which suggests that this specific patient collective may benefit from a higher number of clips.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
International journal of cardiology. Heart & vasculature - 45(2023) vom: 30. Apr., Seite 101190 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sauter, Reinhard [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 22.03.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.ijcha.2023.101190 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354473522 |
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| 024 | 7 | |a 10.1016/j.ijcha.2023.101190 |2 doi | |
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| 041 | |a eng | ||
| 100 | 1 | |a Sauter, Reinhard |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Revised 22.03.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Author(s). | ||
| 520 | |a Background: Percutaneous mitral valve repair (PMVR) has evolved to be a standard procedure in suitable patients with mitral regurgitation (MR) not accessible for open surgery. Here, we analyzed the influence of the number and positioning of the clips implanted during the procedure on MR reduction analyzing also sub-collectives of functional and degenerative MR (DMR) | ||
| 520 | |a Results: We included 410 patients with severe MR undergoing PMVR using the MitraClip® System. MR and reduction of MR were analyzed by TEE at the beginning and at the end of the PMVR procedure. To specify the clip localization, we sub-divided segment 2 into 3 sub-segments using the segmental classification of the mitral valve | ||
| 520 | |a Results: We found an enhanced reduction of MR predominantly in DMR patients who received more than one clip. Implantation of only one clip led to a higher MR reduction in patients with functional MR (FMR) in comparison to patients with DMR. No significant differences concerning pressure gradients could be observed in degenerative MR patients regardless of the number of clips implanted. A deterioration of half a grade of the achieved MR reduction was observed 6 months post-PMVR independent of the number of implanted clips with a better stability in FMR patients, who got 3 clips compared to patients with only one clip | ||
| 520 | |a Conclusions: In patients with FMR, after 6 months the reduction of MR was more stable with an increased number of implanted clips, which suggests that this specific patient collective may benefit from a higher number of clips | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CO, cardiac output | |
| 650 | 4 | |a COe, cardiac output echocardiographically determinded by combination of TTE and TEE parameters | |
| 650 | 4 | |a COi, invasively determined cardiac output | |
| 650 | 4 | |a Clips | |
| 650 | 4 | |a DMR, degenerative mitral regurgitation | |
| 650 | 4 | |a EDV, end-diastolic volume | |
| 650 | 4 | |a EF, ejection fraction | |
| 650 | 4 | |a ESV, end-systolic volume | |
| 650 | 4 | |a Echocardiography | |
| 650 | 4 | |a FMR, functional mitral regurgitation | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Heart geometry | |
| 650 | 4 | |a Hemodynamics | |
| 650 | 4 | |a ICE, intracardiac echocardiography | |
| 650 | 4 | |a IVUS, intravascular ultrasound | |
| 650 | 4 | |a Interventional cardiology | |
| 650 | 4 | |a Interventional therapy | |
| 650 | 4 | |a LA, left atrium | |
| 650 | 4 | |a LV, left ventricle | |
| 650 | 4 | |a LVEDD, left ventricular end diastolic diameter | |
| 650 | 4 | |a MR, mitral regurgitation | |
| 650 | 4 | |a MRI, magnetic resonance imaging | |
| 650 | 4 | |a Mitral regurgitation | |
| 650 | 4 | |a NYHA, New York heart association | |
| 650 | 4 | |a PA, pulmonary artery | |
| 650 | 4 | |a PAP, pulmonary artery pressure | |
| 650 | 4 | |a PASP, pulmonary artery systolic pressure | |
| 650 | 4 | |a PCW, pulmonary capillary wedge | |
| 650 | 4 | |a PCWP, pulmonary capillary wedge pressure | |
| 650 | 4 | |a PHT, pulmonary hypertension | |
| 650 | 4 | |a PMVR | |
| 650 | 4 | |a PMVR, percutaneous mitral valve repair | |
| 650 | 4 | |a RV, right ventricle | |
| 650 | 4 | |a SD, standard deviation | |
| 650 | 4 | |a Structural heart disease | |
| 650 | 4 | |a Surgery | |
| 650 | 4 | |a TAVI, transcatheter aortic valve implantation | |
| 650 | 4 | |a TEE, transesophageal echocardiography | |
| 650 | 4 | |a TTE, transthoracic echocardiography | |
| 700 | 1 | |a Lin, Chaolan |e verfasserin |4 aut | |
| 700 | 1 | |a Magunia, Harry |e verfasserin |4 aut | |
| 700 | 1 | |a Schreieck, Juergen |e verfasserin |4 aut | |
| 700 | 1 | |a Dürschmied, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Gawaz, Meinrad |e verfasserin |4 aut | |
| 700 | 1 | |a Patzelt, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Langer, Harald F |e verfasserin |4 aut | |
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| 773 | 1 | 8 | |g volume:45 |g year:2023 |g day:30 |g month:04 |g pages:101190 |
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