Prevalence of optimal valve morphology for MitraClip in patients with mitral regurgitation
Por:
Ruiz, JMM, Fernandez-Golfin, C, Mesa, D, Gonzalez-Alujas, T, Sitges, M, Carrasco-Chinchilla, F, Li, CH, Grande-Trillo, A, Martinez, A, Matabuena, J, Alonso-Rodriguez, D, Aquila, I, Zamorano, JL
Publicada:
1 ago 2017
Resumen:
Aims: To evaluate how often patients with moderate-to-severe or severe mitral regurgitation (MR) meet the anatomical criteria for MitraClip implant and to examine the role of transthoracic echocardiography (TTE) for this task.
Methods and Results: From February to June 2015, all patients undergoing a TTE in nine Spanish hospitals were prospectively included. Patients with moderate-to-severe and severe mitral regurgitation were selected for analysis. Anatomical eligibility criteria for MitraClip were defined according to the EVEREST trial. A total of 39 855 consecutive TTE were reviewed, and 1403 patients with moderate-to-severe and severe MR were finally included. Primary MR was found in 779 patients (56%). Only in 74 patients (16%), all anatomical criteria for MitraClip could be assessed by TTE. Of these, 56% of patients had optimal valve morphology. Secondary MR was described in 361 patients (26%), and at least 249 of these (69%) had a high surgical risk. All five criteria for MitraClip were adequately assessed by TTE in 299 patients (83%). Of them, 118 patients (39%) had optimal valve morphology.
Conclusions: A considerable proportion of patients have optimal mitral valve morphology for MitraClip. Moreover, TTE was particularly useful in determining whether or not the anatomical criteria for MitraClip implant were met in the majority of patients with secondary MR but in only a minority of those with primary MR.
Filiaciones:
Ruiz, JMM:
Univ Alcala, Hosp Ramon y Cajal, Ctr Res Cardiovasc Dis CIBERCV, Madrid, Spain
Fernandez-Golfin, C:
Univ Alcala, Hosp Ramon y Cajal, Ctr Res Cardiovasc Dis CIBERCV, Madrid, Spain
Mesa, D:
Hosp Reina Sofia, Cardiol Dept, Cordoba, Spain
Gonzalez-Alujas, T:
Hosp Gen Univ Vall dHebron, Cardiol Dept, Barcelona, Spain
Sitges, M:
Univ Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, Thorax Inst, Hosp Clin,Cardiol Dept, Barcelona, Spain
Carrasco-Chinchilla, F:
Hosp Virgen de la Victoria, Cardiol Dept, Malaga, Spain
Li, CH:
Univ Barcelona, Hosp St Pau & Santa Creu, Cardiol Div, Dept Med, Barcelona, Spain
Grande-Trillo, A:
Hosp Virgen del Rocio, Cardiol Dept, Seville, Spain
Martinez, A:
Hosp Clin, Cardiol Dept, Santiago De Compostela, Spain
Matabuena, J:
Hosp Virgen del Rocio, Cardiol Dept, Seville, Spain
Alonso-Rodriguez, D:
Hosp Leon, Cardiol Dept, Leon, Spain
Aquila, I:
Univ Alcala, Hosp Ramon y Cajal, Ctr Res Cardiovasc Dis CIBERCV, Madrid, Spain
Zamorano, JL:
Univ Alcala, Hosp Ramon y Cajal, Ctr Res Cardiovasc Dis CIBERCV, Madrid, Spain
Univ Francisco de Vitoria, Hosp Zarzuela, Madrid, Spain
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