Procedural and clinical outcomes after repeat edge-to-edge transcatheter mitral valve repair
Por:
Freixa, X, Estevez-Loureiro, R, Pascual, I, Carrasco-Chinchilla, F, Sanchis, L, Nombela-Franco, L, Benito, T, Li, P, Flores-Umanzor, E, Amat-Santos, I, Baz, JA, Jimenez-Quevedo, P, Hernandez, F, Fernandez-Peregrina, E, Alonso-Briales, JH, Avanzas, P, Fernandez-Vazquez, F, Arzamendi, D
Publicada:
1 abr 2022
Ahead of Print:
1 ene 2022
Resumen:
Background and Objectives Evidence regarding redo percutaneous interventions for recurrent mitral regurgitation is scarce. We ought to evaluate procedural and clinical outcomes of repeated edge-to-edge transcatheter mitral valve repair (TMVR) interventions. Methods This multicenter study collected individual data from eight high-volume TMVR Centers in Spain. Between 2012 and 2020, all patients undergoing a second edge-to-edge TMVR intervention (Redo) were included in the study. Results Among a total of 1028 procedures, 31 patients (3%) with residual MR >= 3 at follow-up underwent a second procedure (Redo). Redo intervention was mainly conducted between the first and second year after the first procedure. The most common cause of MR progression was partial detachment (46.7%) followed by LV remodeling (35.5%). Procedural success was achieved in 87% of cases. After a mean follow-up of 1.75 +/- 1.54 years, all-cause and cardiovascular mortality were 48.1% and 25%, respectively. Nearly half of the patients (48.1%) required at least one hospital admission for CHF within the follow-up period. However, most of the patients presented symptomatic improvement as depicted by an NYHA class <= 2. Elective mitral surgery was conducted in only one patient at follow-up due to insufficient MR reduction. Conclusions According to our findings, redo edge-to-edge TMVR interventions were feasible and safe with a high procedural success rate. Clinical and echocardiographic follow-up showed however modest long-term results in this specific setting.
Filiaciones:
Freixa, X:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Barcelona, Spain
Estevez-Loureiro, R:
Hosp Univ Vigo, Vigo, Spain
Pascual, I:
Hosp Cent Asturias, Oviedo, Spain
Carrasco-Chinchilla, F:
Hosp Univ Virgen de la Victoria, Malaga, Spain
Sanchis, L:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Barcelona, Spain
Nombela-Franco, L:
Hosp Clin San Carlos, Madrid, Spain
Benito, T:
Hosp Univ Leon, Leon, Spain
Li, P:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Flores-Umanzor, E:
Hosp Clin Barcelona, Inst Clin Cardiovasc, Barcelona, Spain
Amat-Santos, I:
Hosp Clin Univ Valladolid, Valladolid, Spain
Baz, JA:
Hosp Univ Vigo, Vigo, Spain
Jimenez-Quevedo, P:
Hosp Clin San Carlos, Madrid, Spain
Hernandez, F:
Clin Univ Navarra, Pamplona, Spain
Fernandez-Peregrina, E:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Alonso-Briales, JH:
Hosp Univ Virgen de la Victoria, Malaga, Spain
Avanzas, P:
Hosp Cent Asturias, Oviedo, Spain
Fernandez-Vazquez, F:
Hosp Univ Leon, Leon, Spain
Arzamendi, D:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
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