Safety and Feasibility of MitraClip Implantation in Patients with Acute Mitral Regurgitation after Recent Myocardial Infarction and Severe Left Ventricle Dysfunction
Por:
Haberman, D, Estevez-Loureiro, R, Benito-Gonzalez, T, Denti, P, Arzamendi, D, Adamo, M, Freixa, X, Nombela-Franco, L, Villablanca, P, Krivoshei, L, Fam, N, Spargias, K, Czarnecki, A, Pascual, I, Praz, F, Sudarsky, D, Kerner, A, Ninios, V, Gennari, M, Beeri, R, Perl, L, Danenberg, H, Poles, L, Shimoni, S, Goland, S, Caneiro-Queija, B, Scianna, S, Moaraf, I, Schiavi, D, Scardino, C, Corpataux, N, Echarte-Morales, J, Chrissoheris, M, Fernandez-Peregrina, E, Di Pasquale, M, Regueiro, A, Vergara-Uzcategui, C, Iniguez-Romo, A, Fernandez-Vazquez, F, Dvir, D, Taramasso, M, Shuvy, M
Publicada:
1 may 2021
Resumen:
Patients with severe mitral regurgitation (MR) after myocardial infarction (MI) have an increased risk of mortality. Transcatheter mitral valve repair may therefore be a suitable therapy. However, data on clinical outcomes of patients in an acute setting are scarce, especially those with reduced left ventricle (LV) dysfunction. We conducted a multinational, collaborative data analysis from 21 centers for patients who were, within 90 days of acute MI, treated with MitraClip due to severe MR. The cohort was divided according to median left ventricle ejection fraction (LVEF)-35%. Included in the study were 105 patients. The mean age was 71 +/- 10 years. Patients in the LVEF < 35% group were younger but with comparable Euroscore II, multivessel coronary artery disease, prior MI and coronary artery bypass graft surgery. Procedure time was comparable and acute success rate was high in both groups (94% vs. 90%, p = 0.728). MR grade was significantly reduced in both groups along with an immediate reduction in left atrial V-wave, pulmonary artery pressure and improvement in New York Heart Association (NYHA) class. In-hospital and 1-year mortality rates were not significantly different between the two groups (11% vs. 7%, p = 0.51 and 19% vs. 12%, p = 0.49) and neither was the 3-month re-hospitalization rate. In conclusion, MitraClip intervention in patients with acute severe functional mitral regurgitation (FMR) due to a recent MI in an acute setting is safe and feasible. Even patients with severe LV dysfunction may benefit from transcatheter mitral valve intervention and should not be excluded.
Filiaciones:
Haberman, D:
Hebrew Univ Jerusalem, Ctr Heart, Kaplan Med Ctr, IL-9190501 Jerusalem, Israel
Estevez-Loureiro, R:
Hosp Alvaro Cunqueiro, Intervent Cardiol Unit, Vigo 36321, Spain
Benito-Gonzalez, T:
Complejo Asistencial Univ Leon, Intervent Cardiol Unit, Leon 24071, Spain
Denti, P:
San Raffaele Univ Hosp, Cardiovasc Surg Dept, I-20132 Milan, Italy
Arzamendi, D:
Hosp St Pau & Santa Creu, Intervent Cardiol Unit, Barcelona 08041, Spain
Adamo, M:
ASST Spedali Civili Brescia, Cardiac Catheterizat Lab, I-25123 Brescia, Italy
Freixa, X:
Hosp Clin Barcelona, Intervent Cardiol Unit, Barcelona 08036, Spain
Nombela-Franco, L:
IdISSC, Inst Invest Sanitaria San Carlos, Hosp Clin San Carlos, Madrid 28040, Spain
Villablanca, P:
Henry Ford Hosp, Intervent Cardiol, Ctr Struct Heart Dis, Detroit, MI 48202 USA
Krivoshei, L:
Kantonsspital Baden, Dept Cardiol, CH-5404 Baden, Switzerland
Fam, N:
Univ Toronto, St Michaels Hosp, Div Cardiol, Toronto, ON M5B 1W8, Canada
Spargias, K:
HYGEIA Hosp, Dept Transcatheter Heart Valves, Athens 15123, Greece
Czarnecki, A:
Univ Toronto, Schulich Heart Ctr, Sunnybrook Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada
Pascual, I:
Hosp Univ Cent Asturias, Dept Cardiol, Oviedo 33011, Spain
Praz, F:
Univ Bern, Univ Hosp Bern, Inselspital, CH-3010 Bern, Switzerland
Sudarsky, D:
Baruch Padeh Med Ctr, Cardiovasc Inst, IL-1520800 Poriya, Israel
Kerner, A:
Technion Med Sch, Dept Cardiol, Rambam Med Ctr, IL-3109601 Haifa, Israel
Technion Med Sch, B Rappaport Fac Med, IL-3109601 Haifa, Israel
Ninios, V:
Interbalkan European Med Ctr, Dept Cardiol, Thessaloniki 55535, Greece
Gennari, M:
IRCCS Ctr Cardiol Monzino, Dept Cardiovasc Surg, I-20138 Milan, Italy
Univ Hosp Zurich, Heart Valve Clin, CH-8006 Zurich, Switzerland
Beeri, R:
Hadassah Hebrew Univ Med Ctr, Inst Heart, IL-91120 Jerusalem, Israel
Perl, L:
Tel Aviv Univ, Dept Cardiol, Rabin Med Ctr, IL-49100 Tel Aviv, Israel
Tel Aviv Univ, Sackler Fac Med, IL-49100 Tel Aviv, Israel
Danenberg, H:
Hadassah Hebrew Univ Med Ctr, Inst Heart, IL-91120 Jerusalem, Israel
Poles, L:
Hebrew Univ Jerusalem, Ctr Heart, Kaplan Med Ctr, IL-9190501 Jerusalem, Israel
Shimoni, S:
Hebrew Univ Jerusalem, Ctr Heart, Kaplan Med Ctr, IL-9190501 Jerusalem, Israel
Goland, S:
Hebrew Univ Jerusalem, Ctr Heart, Kaplan Med Ctr, IL-9190501 Jerusalem, Israel
Caneiro-Queija, B:
Hosp Alvaro Cunqueiro, Intervent Cardiol Unit, Vigo 36321, Spain
Scianna, S:
Univ Hosp Zurich, Heart Valve Clin, CH-8006 Zurich, Switzerland
Moaraf, I:
Kantonsspital Baden, Dept Cardiol, CH-5404 Baden, Switzerland
Schiavi, D:
San Raffaele Univ Hosp, Cardiovasc Surg Dept, I-20132 Milan, Italy
Scardino, C:
Joan XXIII Univ Hosp, Dept Cardiol, Tarragona 43005, Spain
Corpataux, N:
Univ Bern, Univ Hosp Bern, Inselspital, CH-3010 Bern, Switzerland
Echarte-Morales, J:
Complejo Asistencial Univ Leon, Intervent Cardiol Unit, Leon 24071, Spain
Chrissoheris, M:
HYGEIA Hosp, Dept Transcatheter Heart Valves, Athens 15123, Greece
Fernandez-Peregrina, E:
Hosp St Pau & Santa Creu, Intervent Cardiol Unit, Barcelona 08041, Spain
Di Pasquale, M:
ASST Spedali Civili Brescia, Cardiac Catheterizat Lab, I-25123 Brescia, Italy
Regueiro, A:
Hosp Clin Barcelona, Intervent Cardiol Unit, Barcelona 08036, Spain
Vergara-Uzcategui, C:
IdISSC, Inst Invest Sanitaria San Carlos, Hosp Clin San Carlos, Madrid 28040, Spain
Iniguez-Romo, A:
Hosp Alvaro Cunqueiro, Intervent Cardiol Unit, Vigo 36321, Spain
Fernandez-Vazquez, F:
Complejo Asistencial Univ Leon, Intervent Cardiol Unit, Leon 24071, Spain
Dvir, D:
Hebrew Univ Jerusalem, Shaare Zedek Med Ctr, Jesselson Integrated Heart Ctr, IL-9103102 Jerusalem, Israel
Taramasso, M:
Univ Hosp Zurich, Heart Valve Clin, CH-8006 Zurich, Switzerland
Shuvy, M:
Hadassah Hebrew Univ Med Ctr, Inst Heart, IL-91120 Jerusalem, Israel
Hebrew Univ Jerusalem, Shaare Zedek Med Ctr, Jesselson Integrated Heart Ctr, IL-9103102 Jerusalem, Israel
Green Published, gold
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