Schueler, Robert, Nickenig, Georg, May, Andreas E., Schillinger, Wolfgang, Bekeredjian, Raffi, Ouarrak, Taoufik, Schofer, Joachim, Hehrlein, Christoph, Sievert, Horst, Boekstegers, Peter, Lubos, Edith, Hoffmann, Rainer, Baldus, Stephan, Senges, Jochen and Hammerstingl, Christoph (2016). Predictors for short-term outcomes of patients undergoing transcatheter mitral valve interventions: analysis of 778 prospective patients from the German TRAMI registry focusing on baseline renal function. EuroIntervention, 12 (4). S. 508 - 515. TOULOUSE CEDEX 6: EUROPA EDITION. ISSN 1969-6213

Full text not available from this repository.

Abstract

Aims: Factors predicting outcomes after MitraClip implantation are not well defined. We aimed to report the influence of baseline renal function on short-term outcomes of patients enrolled in the investigator-initiated German transcatheter mitral valve interventions (TRAMI) registry. Methods and results: Twenty participating German centres prospectively included 778 patients (mean age 76.0 years [71-81], 38.8% female gender) at high surgical risk (mean logistic EuroSCORE 20% [12-32%]) undergoing TMVR with the MitraClip for the treatment of symptomatic functional (70%) or degenerative (30%) mitral valve regurgitation (FMR, DMR). The patients were stratified according to renal function before clip implantation. The prevalence of moderate to severe renal impairment (glomerular filtration rate [GFR] < 60 ml/min) was 62.7% (37.3%, normal renal function [GFR > 60 ml/min]; 49.6%, moderate renal impairment [GFR 30-60 ml/min]; 13.1%, severe renal impairment [GFR < 30 ml/min]). TMVR was successfully completed in 98.2% of cases; acute procedural failure, in-hospital and 30-day mortality rates were 1.8%, 2.3% and 4.4%, respectively. Acute procedural failure and mortality rates (in-hospital, 30-day) were significantly higher in patients with severe renal impairment (5.9%, 7.8%, 14.1%), as compared to patients with moderately (1%, 1.3%, 3.0%) or mildly impaired to normal (1.4%, 1.7%, 2.9%) renal function (p < 0.0001). Following Cox regression analysis, the prevalence of severe renal impairment at the time of TMVR was the only predictor for increased 30-day mortality rates (hazard ratio 3.42, 95% confidence interval 1.88-6.2; p < 0.0001). Conclusions: Renal function at the time of interventional mitral valve repair with the MitraClip system is a strong predictor for procedural outcomes. Patients with severe renal impairment have a more than threefold increased risk for acute procedural failure, in-hospital death and 30-day mortality.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schueler, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nickenig, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
May, Andreas E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schillinger, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bekeredjian, RaffiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ouarrak, TaoufikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schofer, JoachimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hehrlein, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sievert, HorstUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boekstegers, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lubos, EdithUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoffmann, RainerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baldus, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Senges, JochenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hammerstingl, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-271421
Journal or Publication Title: EuroIntervention
Volume: 12
Number: 4
Page Range: S. 508 - 515
Date: 2016
Publisher: EUROPA EDITION
Place of Publication: TOULOUSE CEDEX 6
ISSN: 1969-6213
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HEART-FAILURE; DYSFUNCTION; SURGERY; REPAIR; RISK; REGURGITATION; METAANALYSIS; IMPAIRMENT; MORTALITY; SURVIVALMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/27142

Downloads

Downloads per month over past year

Export

Actions (login required)

View Item View Item