Universität zu Köln

Karam, Nicole ORCID: 0000-0002-3861-6914, Orban, Mathias, Kalbacher, Daniel, Butter, Christian, Praz, Fabien ORCID: 0000-0001-5416-165X, Lubos, Edith, Bannehr, Marwin, Kassar, Mohammad, Petrescu, Aniela, Iliadis, Christos, Unterhuber, Matthias ORCID: 0000-0002-8175-276X, Asselin, Anouk, Thiele, Holger, Pfister, Roman, Windecker, Stephan, Lurz, Philipp, von Bardeleben, Stephan and Hausleiter, Joerg (2021). Impact of effective regurgitant orifice area on outcome of secondary mitral regurgitation transcatheter repair. Clin. Res. Cardiol., 110 (5). S. 732 - 740. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Objectives To assess the value of effective regurgitant orifice (ERO) in predicting outcome after edge-to-edge transcatheter mitral valve repair (TMVR) for secondary mitral regurgitation (SMR) and identify the optimal cut-off for patients' selection. Methods Using the EuroSMR (European Registry of Transcatheter Repair for Secondary Mitral Regurgitation) registry, that included patients undergoing edge-to-edge TMVR for SMR between November 2008 and January 2019 in 8 experienced European centres, we assessed the optimal ERO threshold associated with mortality in SMR patients undergoing TMVR, and compared characteristics and outcomes of patients according to baseline ERO. Results Among 1062 patients with severe SMR and ERO quantification by proximal isovelocity surface area method in the registry, ERO was < 0.3 cm(2) in 575 patients (54.1%), who were more symptomatic at baseline (NYHA class >= III: 91.4% vs. 86.9%, for ERO < vs. >= 0.3 cm(2); P = 0.004). There was no difference in all-cause mortality at 2-year follow-up according to baseline ERO (28.3% vs. 30.0% for ERO < vs. >= 0.3 cm(2), P = 0.585). Both patient groups demonstrated significant improvement of at least one NYHA class (61.7% and 73.8%, P = 0.002), resulting in a prevalence of NYHA class <= II at 1-year follow-up of 60.0% and 67.4% for ERO < vs. >= 0.3 cm(2), respectively (P = 0.05). Conclusion All-cause mortality at 2 years after TMVR does not differ if baseline ERO is < or >= 0.3 cm(2), and both groups exhibit relevant clinical improvements. Accordingly, TMVR should not be withheld from patients with ERO < 0.3 cm(2) who remain symptomatic despite optimal medical treatment, if TMVR appropriateness was determined by experienced teams in dedicated valve centres.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Karam, Nicole UNSPECIFIED orcid.org/0000-0002-3861-6914 UNSPECIFIED Orban, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalbacher, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Butter, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Praz, Fabien UNSPECIFIED orcid.org/0000-0001-5416-165X UNSPECIFIED Lubos, Edith UNSPECIFIED UNSPECIFIED UNSPECIFIED Bannehr, Marwin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kassar, Mohammad UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrescu, Aniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Unterhuber, Matthias UNSPECIFIED orcid.org/0000-0002-8175-276X UNSPECIFIED Asselin, Anouk UNSPECIFIED UNSPECIFIED UNSPECIFIED Thiele, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Windecker, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lurz, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bardeleben, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hausleiter, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-602128
DOI:	10.1007/s00392-021-01807-0
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	110
Number:	5
Page Range:	S. 732 - 740
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VALVE REPAIR; CONSERVATIVE TREATMENT; SURGERY; SURVIVAL; RISK Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60212