Universität zu Köln

Koerber, Maria Isabel, Silwedel, Julia, Friedrichs, Kai, Mauri, Victor, Huntgeburth, Michael, Pfister, Roman, Baldus, Stephan and Rudolph, Volker (2018). Bleeding Complications After Percutaneous Mitral Valve Repair With the MitraClip. Am. J. Cardiol., 121 (1). S. 94 - 100. BRIDGEWATER: EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC. ISSN 1879-1913

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Abstract

Bleeding after cardiac surgery or cardiovascular interventions is associated with worse patient outcome. Only very limited data are available on the subject of bleeding after percutaneous edge-to-edge mitral valve repair (PMVR). We performed a single center analysis including 347 consecutive patients who underwent PMVR. Bleeding was defined according to the Mitral Valve Academic Research Consortium (MVARC) end point definition. The incidence of MVARC bleeding was 21.6% (n = 75), whereas major MVARC bleeding (hemoglobin decrease >= 3 g/dl) occurred in 7.4% (n = 26). Only 33.3% of all bleeding cases were access site related. In multivariate regression analyses, independent predictors of MVARC bleeding were the presence of coronary artery disease (2.809, 95% CI 1.123 to 7.022, p = 0.027) and intervention duration (1.010, 95% CI 1.002 to 1.018, p = 0.010). Patients experiencing MVARC bleeding had longer hospital stays (p = 0.026); however, neither major nor extensive MVARC bleeding was associated with increased 30-day or 1-year mortality. A decrease in hemoglobin levels >= 3 g/dl without clinically visible bleeding sign not considered in the MVARC bleeding definition occurred in 9.5% of patients. A hemoglobin decrease of >= 4 g/dl had a strong association with worse survival in those patients with obscure bleeding. In conclusion, these data show a relevant incidence of bleeding after PMVR. In contrast to other cardiovascular interventions, the majority of bleedings were not access site-related. Particularly, patients with obscure bleeding, which are not included in the MVARC end point definitions, had worse outcomes and should therefore be considered for a more intensive workup. (C) 2017 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koerber, Maria Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Silwedel, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrichs, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Huntgeburth, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-204649
DOI:	10.1016/j.amjcard.2017.09.027
Journal or Publication Title:	Am. J. Cardiol.
Volume:	121
Number:	1
Page Range:	S. 94 - 100
Date:	2018
Publisher:	EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Place of Publication:	BRIDGEWATER
ISSN:	1879-1913
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE KIDNEY INJURY; ACUTE CORONARY SYNDROMES; CLINICAL-TRIAL; INTERVENTIONS; REPLACEMENT; RISK; REGURGITATION; IMPLANTATION; CONSORTIUM; EXPERIENCE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20464