Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device
Por:
Freixa, X, Estevez-Loureiro, R, Carrasco-Chinchilla, F, Millan, X, Amat-Santos, I, Regueiro, A, Nombela-Franco, L, Pascual, I, Cid, B, Lopez-Minguez, JR, Hernandez-Antolin, RA, Cruz-Gonzalez, I, Andraka, L, Goicolea, J, Ruiz-Quevedo, V, Diez, JL, Berenguer, A, Baz, JA, Pan, MU, Benito-Gonzalez, T, Briales, JHA, Li, CH, Sanchis, L, Serrador, A, Jimenez-Quevedo, P, Avanzas, P, Salido, L, Fernandez-Vazquez, F, Hernandez-Garcia, JM, Arzamendi, D
Publicada:
1 feb 2021
Resumen:
Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system. Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017. The cohort was divided into three groups according to the use of the first-generation Mitraclip during the first (control-1) or second half (control-2) or the Mitraclip NT system. Results: A total of 545 consecutive patients were included in the study. Among all, 182 (33.3%), 183 (33.3%), and 180 (33.3%) patients underwent mitral repair in the control-1, control-2, and NT cohorts, respectively. Procedural success was achieved in 93.3% of patients without differences between groups. Major adverse events did not statistically differ among groups, but there was a higher rate of pericardial effusion in the control-1 group (4.3%, 0.6%, and 2.6%, respectively; p = 0.025). The composite endpoint of death, surgery, and admission for congestive heart failure (CHF) at 12 months was lower in the NT group (23.5% in control-1, 22.5% in control-2, and 8.3% in the NT group; p = 0.032). Conclusions: The present paper shows that contemporary clinical outcomes of patients undergoing PMVR with the Mitraclip system have improved over time.
Filiaciones:
Freixa, X:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Barcelona 08036, Spain
Estevez-Loureiro, R:
Hosp Univ Leon, Leon 24071, Spain
Carrasco-Chinchilla, F:
Hosp Univ Virgen de la Victoria, Malaga 29010, Spain
Millan, X:
Hosp Santa Creu & Sant Pau, Barcelona 08041, Spain
Amat-Santos, I:
Hosp Clin Univ Valladolid, Valladolid 47003, Spain
Regueiro, A:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Barcelona 08036, Spain
Nombela-Franco, L:
Hosp Clin San Carlos, Madrid 28040, Spain
Pascual, I:
Hosp Cent Asturias, Oviedo 33011, Spain
Cid, B:
Complejo Hosp Univ Santiago, Santiago De Compostela 15706, Spain
Lopez-Minguez, JR:
Hosp Univ Infanta Cristina, Badajoz 06080, Spain
Hernandez-Antolin, RA:
Hosp Ramon & Cajal, Madrid 28034, Spain
Cruz-Gonzalez, I:
Hosp Clin Univ Salamanca, Salamanca 37007, Spain
Andraka, L:
Hosp Civil Basurto, Basurto 48013, Spain
Goicolea, J:
Hosp Puerta de Hierro, Madrid 28222, Spain
Ruiz-Quevedo, V:
Complejo Hosp Navarra, Pamplona 31008, Spain
Diez, JL:
Hosp La Fe Valencia, Valencia 46026, Spain
Berenguer, A:
Hosp Gen Univ Valencia, Valencia 46014, Spain
Baz, JA:
Complejo Hosp Univ Vigo, Vigo 36310, Spain
Pan, MU:
Hosp Reina Sofia Cordoba, Cordoba 14004, Spain
Benito-Gonzalez, T:
Hosp Univ Leon, Leon 24071, Spain
Briales, JHA:
Hosp Univ Virgen de la Victoria, Malaga 29010, Spain
Li, CH:
Hosp Santa Creu & Sant Pau, Barcelona 08041, Spain
Sanchis, L:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Barcelona 08036, Spain
Serrador, A:
Hosp Clin Univ Valladolid, Valladolid 47003, Spain
Jimenez-Quevedo, P:
Hosp Clin San Carlos, Madrid 28040, Spain
Avanzas, P:
Hosp Cent Asturias, Oviedo 33011, Spain
Salido, L:
Hosp Ramon & Cajal, Madrid 28034, Spain
Fernandez-Vazquez, F:
Hosp Univ Leon, Leon 24071, Spain
Hernandez-Garcia, JM:
Hosp Univ Virgen de la Victoria, Malaga 29010, Spain
Arzamendi, D:
Hosp Santa Creu & Sant Pau, Barcelona 08041, Spain
gold, Green Published
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