Universität zu Köln

Huntgeburth, Michael, Schier, Robert, Pfister, Roman, ten Freyhaus, Henrik, Dahlem, Kristina, Friedrichs, Kai, Baldus, Stephan and Rudolph, Volker (2017). End-Tidal CO2 Predicts Reduction in Mitral Regurgitation in Patients Undergoing Percutaneous Mitral Valve Edge-to-Edge Repair. Cardiology, 137 (3). S. 151 - 159. BASEL: KARGER. ISSN 1421-9751

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Abstract

Objectives: We evaluated end-tidal CO2 (etCO(2)), which has been proposed to assess acute hemodynamic changes, to guide percutaneous edge-to-edge mitral valve repair (PMVR) with the MitraClip system. Methods: Thirty-nine patients (aged 78 +/- 14 years) undergoing PMVR for moderate-to-severe mitral regurgitation (MR) of primary and secondary etiology were included. General anesthesia was maintained with sevoflurane and constant ventilation parameters to ensure stable etCO(2) tension. MR grade was determined semi-quantitatively by transesophageal echocardiography by 2 experienced operators blinded to etCO(2) measurements. etCO(2) levels were measured 3, 5, 10, and 15 min after final MitraClip placement. Results: Overall, etCO(2) increased from 32.2 +/- 1.7 before to 35.4 +/- 3.0, 34.6 +/- 2.6, and 34.2 +/- 2.4 mm Hg 3, 5, and 10 min after implantation. A significant correlation was noted between the echocardiographic reduction in MR grade and the increase in etCO(2). ANOVA for repeated measures confirmed a significant increase in etCO(2) after clip implantation corrected F = 20.0; p < 0.001) and revealed a significantly greater increase in etCO2 in patients with MR reduction = 2 grades as compared to lesser MR reductions (F = 6.47; p = 0.015). Blood pressure changes did not correlate with the degree of MR reduction. Conclusions: We observed a close correlation between the reduction in MR grade during PMVR and etCO(2), which might evolve as a useful parameter to complement treatment guidance during PMVR. (C) 2017 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Huntgeburth, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Schier, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED ten Freyhaus, Henrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Dahlem, Kristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrichs, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-246108
DOI:	10.1159/000458704
Journal or Publication Title:	Cardiology
Volume:	137
Number:	3
Page Range:	S. 151 - 159
Date:	2017
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9751
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARBON-DIOXIDE; EAE/ASE RECOMMENDATIONS; ARTERIAL-PRESSURE; ECHOCARDIOGRAPHY; SHOCK Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24610