Universität zu Köln

Weber, Marcel, Ozturk, Can, Taramasso, Maurizio, Pozzoli, Alberto, Pfister, Roman, Wosten, Monique, Alessandrini, Hannes, Latib, Azeem, Denti, Paolo, Kuck, Karl-Heinz, Maisano, Francesco, Baldus, Stephan and Nickenig, Georg (2019). Leaflet edge-to-edge treatment versus direct annuloplasty in patients with functional mitral regurgitation. EuroIntervention, 15 (10). S. 912 - 919. TOULOUSE CEDEX 6: EUROPA EDITION. ISSN 1969-6213

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Abstract

Aims: Interventional mitral repair techniques have evolved as safe and effective treatment options for patients with functional mitral regurgitation (FMR) at high or prohibitive surgical risk. Of the techniques available, the MitraClip device and Cardioband mitral repair system have been used most commonly. However, a direct comparison of the two devices, examining their effectiveness at reducing MR, reducing symptoms, and extending life expectancy, has not yet been performed. For this purpose, we compared the outcome of patients after direct annuloplasty by the Cardioband system with patients after edge-to-edge therapy with the MitraClip device in a propensity score-matched analysis. Methods and results: We collected data concerning 123 consecutive patients who were treated with the Cardioband device and 455 consecutive patients treated with the MitraClip from five experienced European centres. Propensity score matching was performed, resulting in two groups with 93 patients each - with no significant differences regarding baseline demographic parameters - who underwent standardised 2D transthoracic echocardiography with assessment at baseline and clinical follow-up at 12 months. The success rate, defined as a reduction of MR to grade 2 or lower, was high in both groups (MR <= 2: MitraClip: 86%, Cardioband: 77%, p=0.18). The Cardioband was better at reducing heart failure symptoms (NYHA <= II: 88%) than the MitraClip (75%) procedure (p=0.046) at 12-month follow-up. All-cause rehospitalisation and mortality within 12 months were lower in Cardioband patients (mortality: OR 0.30, CI: 0.09-0.98, p=0.032; rehospitalisation: OR 0.57, CI: 0.28-0.97, p=0.03). Conclusions: The MitraClip and the Cardioband procedures effectively reduce MR and heart failure symptoms. However, patients undergoing the Cardioband procedure showed a more pronounced improvement with regard to functional NYHA class, rehospitalisation, and mortality, compared to patients undergoing the MitraClip procedure.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weber, Marcel UNSPECIFIED UNSPECIFIED UNSPECIFIED Ozturk, Can UNSPECIFIED UNSPECIFIED UNSPECIFIED Taramasso, Maurizio UNSPECIFIED UNSPECIFIED UNSPECIFIED Pozzoli, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Wosten, Monique UNSPECIFIED UNSPECIFIED UNSPECIFIED Alessandrini, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Latib, Azeem UNSPECIFIED UNSPECIFIED UNSPECIFIED Denti, Paolo UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuck, Karl-Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Maisano, Francesco UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-129223
DOI:	10.4244/EIJ-D-19-00468
Journal or Publication Title:	EuroIntervention
Volume:	15
Number:	10
Page Range:	S. 912 - 919
Date:	2019
Publisher:	EUROPA EDITION
Place of Publication:	TOULOUSE CEDEX 6
ISSN:	1969-6213
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EUROPEAN ASSOCIATION; VALVE REPAIR; SURGERY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12922