Transcatheter mitral repair according to the cause of mitral regurgitation: real-life data from the Spanish MitraClip registry
Por:
Pascual, I, Arzamendi, D, Carrasco-Chinchilla, F, Fernandez-Vazquez, F, Freixa, X, Nombela-Franco, L, Avanzas, P, Frutos, AMS, Pan, M, Alvarez, ABC, Hernandez-Antolin, RA, Ikazuriaga, LA, Cruz-Gonzalez, I, Gil, JLD, Juango, MSA, Jofresa, AB, Alonso-Briales, JH, Li, CH, Gonzalez, TB, Regueiro, A, Armijo, G, Leon, V, Amat-Santos, IJ, Romero, M, Nouche, RT, Fernandez-Golfin, C, Gomez, LR, Campos-Arjona, R, Millan, X, Coloma, CG, Sanchis, L, Jimenez-Quevedo, P, Moris, C, Hernandez-Garcia, JM, Serra, A, de Prado, AP, Estevez-Loureiro, R
Publicada:
1 ago 2020
Resumen:
Introduction and objectives: Transcatheter mitral valve repair (TMVR) with MitraClip is a therapeutic option for high surgical risk patients with severe mitral regurgitation (MR). The main objective of this study was to analyze differences in outcomes in patients with severe MR according to the cause of MR.
Methods: Observational, multicenter, and prospective study with consecutive patient inclusion. The primary endpoint was the combination of all-cause mortality and new readmissions due to heart failure after 1 year. We compared clinical and procedural characteristics and the event rate for each MR group. We performed a multivariate analysis to identify predictive variables for the primary endpoint.
Results: A total of 558 patients were included: 364 (65.2%) with functional etiology, 111 (19.9%) degenerative and 83 (14.9%) mixed. The mean age was 72.8 +/- 11.1 years and 70.3% of the sample were men. There were 95 (17%) events in the overall sample. No significant differences were found in the 3 groups in the number of primary outcome events: 11 (11.3%) in degenerative MR, 71 (21.3%) in functional MR, and 13 (18.1%) in mixed MR (P=.101). Independent predictors were functional class (P=.029), previous surgical revascularization (P=.031), EuroSCORE II (P=.003), diabetes mellitus (P=.037), and left ventricular ejection fraction (P=.015).
Conclusions: This study confirms the safety and efficacy of TMVR with MitraClip irrespective of MR etiology in real-life data and shows the main factors related to prognosis during the first year of follow up. (C) 2019 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
Filiaciones:
Pascual, I:
Hosp Univ Cent Asturias, Area Corazon, Avda Roma S-N, Oviedo 33011, Asturias, Spain
Inst Invest Sanitaria Principado Asturias, Oviedo, Asturias, Spain
Univ Oviedo, Dept Biol Func, Oviedo, Asturias, Spain
Arzamendi, D:
Hosp Santa Creu & Sant Pau, Serv Cardiol, Barcelona, Spain
Carrasco-Chinchilla, F:
Hosp Clin Univ Virgen de la Victoria, Serv Cardiol, Malaga, Spain
Fernandez-Vazquez, F:
Complejo Hosp Leon, Serv Cardiol, Leon, Spain
Freixa, X:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Serv Cardiol, Barcelona, Spain
Nombela-Franco, L:
Hosp Clin San Carlos, Inst Cardiovasc, Madrid, Spain
Avanzas, P:
Hosp Univ Cent Asturias, Area Corazon, Avda Roma S-N, Oviedo 33011, Asturias, Spain
Inst Invest Sanitaria Principado Asturias, Oviedo, Asturias, Spain
Univ Oviedo, Dept Biol Func, Oviedo, Asturias, Spain
Frutos, AMS:
Hosp Clin Univ Valladolid, Inst Ciencias Corazon, Valladolid, Spain
Pan, M:
Hosp Univ Reina Sofia, Serv Cardiol, Cordoba, Spain
Alvarez, ABC:
Complejo Hosp Univ Santiago de Compostela, Serv Cardiol, CIBERCV, Santiago De Compostela, A Coruna, Spain
Hernandez-Antolin, RA:
Hosp Univ Ramon y Cajal, Serv Cardiol, Madrid, Spain
Ikazuriaga, LA:
Hosp Univ Basurto, Serv Cardiol, Bilbao, Vizcaya, Spain
Cruz-Gonzalez, I:
Hosp Univ Salamanca, Serv Cardiol, Salamanca, Spain
Gil, JLD:
Hosp Univ & Politecn La Fe Valencia, Serv Cardiol, Valencia, Spain
Juango, MSA:
Complejo Hosp Navarra, Area Clin Corazon, Navarra, Spain
Jofresa, AB:
Hosp Gen Valencia, Serv Cardiol, Valencia, Spain
Alonso-Briales, JH:
Hosp Clin Univ Virgen de la Victoria, Serv Cardiol, Malaga, Spain
Li, CH:
Hosp Santa Creu & Sant Pau, Serv Cardiol, Barcelona, Spain
Gonzalez, TB:
Complejo Hosp Leon, Serv Cardiol, Leon, Spain
Regueiro, A:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Serv Cardiol, Barcelona, Spain
Armijo, G:
Hosp Clin San Carlos, Inst Cardiovasc, Madrid, Spain
Leon, V:
Hosp Univ Cent Asturias, Area Corazon, Avda Roma S-N, Oviedo 33011, Asturias, Spain
Inst Invest Sanitaria Principado Asturias, Oviedo, Asturias, Spain
Amat-Santos, IJ:
Hosp Clin Univ Valladolid, Inst Ciencias Corazon, Valladolid, Spain
Romero, M:
Hosp Clin Univ Valladolid, Inst Ciencias Corazon, Valladolid, Spain
Nouche, RT:
Complejo Hosp Univ Santiago de Compostela, Serv Cardiol, CIBERCV, Santiago De Compostela, A Coruna, Spain
Fernandez-Golfin, C:
Hosp Univ Ramon y Cajal, Serv Cardiol, Madrid, Spain
Gomez, LR:
Hosp Univ Basurto, Serv Cardiol, Bilbao, Vizcaya, Spain
Campos-Arjona, R:
Univ Oviedo, Dept Biol Func, Oviedo, Asturias, Spain
Millan, X:
Hosp Santa Creu & Sant Pau, Serv Cardiol, Barcelona, Spain
Coloma, CG:
Complejo Hosp Leon, Serv Cardiol, Leon, Spain
Sanchis, L:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Serv Cardiol, Barcelona, Spain
Jimenez-Quevedo, P:
Hosp Clin San Carlos, Inst Cardiovasc, Madrid, Spain
Moris, C:
Hosp Univ Cent Asturias, Area Corazon, Avda Roma S-N, Oviedo 33011, Asturias, Spain
Inst Invest Sanitaria Principado Asturias, Oviedo, Asturias, Spain
Univ Oviedo, Dept Biol Func, Oviedo, Asturias, Spain
Hernandez-Garcia, JM:
Hosp Clin Univ Virgen de la Victoria, Serv Cardiol, Malaga, Spain
Serra, A:
Hosp Santa Creu & Sant Pau, Serv Cardiol, Barcelona, Spain
de Prado, AP:
Complejo Hosp Leon, Serv Cardiol, Leon, Spain
Estevez-Loureiro, R:
Complejo Hosp Univ Vigo, Area Cardiol, Vigo, Pontevedra, Spain
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