Ontology highlight
ABSTRACT: Background
Patients after transcatheter aortic valve replacement (TAVR) and persistent severe mitral regurgitation (MR) are increasingly treated with percutaneous edge-to-edge mitral valve repair (PMVR). The impact of a former TAVR on PMVR procedures is not clear.Methods and results
We retrospectively analyzed 332 patients undergoing PMVR using the MitraClip system with respect to procedural and clinical outcome. 21 of these 332 patients underwent TAVR before PMVR. Intra-procedural transthoracic (TTE) and transesophageal echocardiograms (TEE) immediately before and after clip implantation as well as invasive hemodynamic measurements were evaluated. At baseline, we found a significantly smaller mitral valve anterior-posterior diameter in the TAVR cohort (p < 0.001). A reduction of MR by at least three grades was achieved in a smaller fraction in the TAVR cohort as compared to the cohort with a native aortic valve (p = 0.02). Accordingly, we observed a smaller post-procedural cardiac output in the TAVR cohort (p = 0.02).Conclusion
PMVR in patients who had a TAVR before, is associated with altered MR anatomy before and a reduced improvement of MR after the procedure. Future larger and prospective studies will have to determine, whether a previous TAVR influences long-term clinical outcome of patients undergoing PMVR.
SUBMITTER: Patzelt J
PROVIDER: S-EPMC6195292 | biostudies-literature | 2018
REPOSITORIES: biostudies-literature
Patzelt Johannes J Ulrich Miriam M Becker Annika A Müller Karin A L KAL Jorbenadze Rezo R Droppa Michal M Zhang Wenzhong W Mandel Sarah S Habel Lisa L Lausberg Henning H Pöss Janine J Geisler Tobias T Borst Oliver O Rosenberger Peter P Schlensak Christian C Gawaz Meinrad M Schreieck Jürgen J Seizer Peter P Langer Harald F HF
PloS one 20181019 10
<h4>Background</h4>Patients after transcatheter aortic valve replacement (TAVR) and persistent severe mitral regurgitation (MR) are increasingly treated with percutaneous edge-to-edge mitral valve repair (PMVR). The impact of a former TAVR on PMVR procedures is not clear.<h4>Methods and results</h4>We retrospectively analyzed 332 patients undergoing PMVR using the MitraClip system with respect to procedural and clinical outcome. 21 of these 332 patients underwent TAVR before PMVR. Intra-procedur ...[more]