Universität zu Köln

Koerber, Maria Isabel, Friedrichs, Kai Peter, Aydin, Fatma, Pfister, Roman, Mauri, Victor, Baldus, Stephan, Rudolph, Volker and Huntgeburth, Michael . Impact of cleft-like indentations on procedural outcome of percutaneous edge-to-edge mitral valve repair. Catheter. Cardiovasc. Interv.. HOBOKEN: WILEY. ISSN 1522-726X

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Abstract

Objectives and Background Percutaneous edge-to-edge mitral valve (MV) repair (PMVR) is broadly applied in high-risk patients with relevant mitral regurgitation (MR). We investigated the incidence of cleft-like indentations (CLI) and their impact on PMVR. Methods and Results In a retrospective single center analysis including 263 patients undergoing PMVR with the MitraClip (R)-system between 11/2012 and 7/2016, MV anatomy was assessed by 3-dimensional transesophageal echocardiography. CLI were present in 37/263 patients (14.1%). Of these, 62.2% had 1 CLI, 27% had 2 CLI, and 10.8% had 3 CLI, mostly concerning segment P2 or P2/3 of the MV. Baseline characteristics were similarly distributed. Interestingly, most patients with CLI suffered from secondary MR (n= 29, 78%). The number of deployed MitraClips was higher in patients with CLI (2 [1.25-2] vs. 2 [1, 2],p= .035), whereas procedural as well as clinical success was similar: MR grade (1.2 vs. 1.5,p= .061), vena contracta width (4.2 vs. 4.5 mm,p= .293), dPmean (4.2 vs. 4.0 mmHg,p= .618) at discharge and NYHA class at 30 days did not differ between groups. Periprocedural complications were rare and equally distributed between groups. At 30 days, MR reduction persisted in patients with CLI (95.8% of these selected patients had a MR grade <= 2). Conclusions CLI of the MV are common in patients undergoing PMVR, also when presenting mainly with secondary MR. While the number of clips needed to address MR is slightly higher in patients with CLI, procedural success rates appear not to be affected. PMVR seems to be a safe treatment option for patients with CLI.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koerber, Maria Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Friedrichs, Kai Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Aydin, Fatma UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Mauri, Victor UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Huntgeburth, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-317535
DOI:	10.1002/ccd.29286
Journal or Publication Title:	Catheter. Cardiovasc. Interv.
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1522-726X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PSEUDO-CLEFT; REGURGITATION; THERAPY; ECHOCARDIOGRAPHY; RISK; MANAGEMENT; SOCIETY; SURGERY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31753