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1. External Validation of COAPT Risk Score in Patients Who Underwent Transcatheter Edge-To-Edge Repair of Severe, Functional Mitral Regurgitation: A Multicenter, Observational Italian-Polish Study

Author

Gąsecka, Aleksandra, Jasińska-Gniadzik, Karolina, D'Ascenzo, Fabrizio, Angelini, Filippo, Łomiak, Michał, Pręgowski, Jerzy, Chmielak, Zbigniew, Kasprzyk, Piotr, Kasprzyk, Jan, Jaguszewski, Miłosz J., Fijałkowski, Marcin, Chmielecki, Michal, Gałąska, Rafał, Grabowski, Marcin, Kochman, Janusz, Rdzanek, Adam, Kołtowski, Łukasz, Budnik, Monika, Piątkowski, Radosław, Scisło, Piotr, Kapłon-Cieślicka, Agnieszka, Główczyńska, Renata, Cavallone, Elena, Montefusco, Antonio, Raineri, Claudia, Dusi, Veronica, Bocchino, Pier Paolo, Boretto, Paolo, Frea, Simone, Pidello, Stefano, De Ferrari, Gaetano Maria, and Pietrasik, Arkadiusz

Published
2025
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3. Prognostic implications of pulmonary artery catheter monitoring in patients with cardiogenic shock: A systematic review and meta-analysis of observational studies

Author

Bertaina, Maurizio, Galluzzo, Alessandro, Rossello, Xavier, Sbarra, Pierluigi, Petitti, Elisabetta, Prever, Silvia Brach, Boccuzzi, Giacomo, D'Ascenzo, Fabrizio, Frea, Simone, Pidello, Stefano, Morici, Nuccia, Sacco, Alice, Oliva, Fabrizio, Valente, Serafina, De Ferrari, Gaetano Maria, Ugo, Fabrizio, Rametta, Francesco, Attisani, Matteo, Zanini, Paola, Noussan, Patrizia, and Iannaccone, Mario

Published
2022
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4. Mitral Transcatheter Edge-to-Edge Repair in INTERMACS 3–4 Profile Patients with Severe Mitral Regurgitation.

Author

Frea, Simone, Pidello, Stefano, Angelini, Filippo, Boretto, Paolo, Bocchino, Pier Paolo, Melis, Daniele, Giannino, Giuseppe, Cavallone, Elena, Giordana, Francesca, Rettegno, Sara, Gravinese, Carol, De Lio, Giulia, Gallone, Guglielmo, Dusi, Veronica, Alunni, Gianluca, Montefusco, Antonio, D'Ascenzo, Fabrizio, Boffini, Massimo, Raineri, Claudia, and Rinaldi, Mauro

Published
2024
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8. Transcatheter aortic valve implantation versus surgery: 4-year survival according to life expectancy.

Author

Lodo, Vittoria, Italiano, Enrico G., Zingarelli, Edoardo, Pietropaolo, Claudio, Pidello, Stefano, Buono, Gabriella, and Centofanti, Paolo

Subjects
MORTALITY risk factors, BUNDLE-branch block, LIFE expectancy, MULTIPLE regression analysis, DESCRIPTIVE statistics, MULTIVARIATE analysis, ACUTE kidney failure, HEART valve prosthesis implantation, KAPLAN-Meier estimator, SURGICAL complications, AORTIC stenosis, REOPERATION, SURVIVAL analysis (Biometry), CARDIAC pacemakers
Abstract

Background In the last years, transcatheter aortic valve implantation (TAVI) indication has expanded to younger and lower risk patients. Consequently, interest in mid and long-term follow up and in the role of life expectancy, as a key factor for selecting the most tailored treatment, has grown. The aim of this retrospective study is to compare the 4-year survival of patients who underwent aortic valve replacement (AVR) vs. TAVI at our department. Methods From September 2017 to December 2020, 673 consecutive patients with severe aortic valve stenosis were enrolled for AVR (n = 283) or TAVI (n = 390). Inclusion criteria was isolated severe aortic stenosis, while exclusion criteria were redo surgery, valve-in-valve procedure and the need for concomitant surgical procedures. Based on the Lee index, patients were divided into four groups according to their 4-year life expectancy. Four-year survival was assessed and reported using the Kaplan-Meier method. A multivariate regression analysis of risk factors for 4-year mortality was performed. Results Four years survival is always superior in the AVR patients (89.8% vs. 75.6%, P < 0.001). Surgery is associated with a higher incidence of acute kidney injury (23% vs. 5.1%, P < 0.001), while TAVI is related to a higher incidence of new onset left bundle branch block (0 vs. 23.8%, P < 0.001), pace-maker implantation (2.5% vs. 11.8%, P = 0,02) and mild-to-moderate paravalvular leak (0.3% vs. 5.4%, P < 0.001). The independent risk factors for 4-years mortality are post-procedural AKI, poor mobility and transcatheter procedure. Conclusion In our analysis, 4 years survival is always superior in the AVR patients. Life expectancy is a key factor for selecting the most appropriate approach for each patient. A longer follow up is mandatory before extending TAVI indication to patients with a long-life expectancy. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Association of Renin‐Angiotensin‐Aldosterone System Inhibitors With Clinical Outcomes, Hemodynamics, and Myocardial Remodeling Among Patients With Advanced Heart Failure on Left Ventricular Assist Device Support

Author

Gallone, Guglielmo, primary, Ibero, Javier, additional, Morley‐Smith, Andrew, additional, Monteagudo Vela, Maria, additional, Fiorelli, Francesca, additional, Konicoff, Mailen, additional, Edwards, Gemma, additional, Raj, Binu, additional, Shanmuganathan, Mayooran, additional, Pidello, Stefano, additional, Frea, Simone, additional, De Ferrari, Gaetano Maria, additional, Panoulas, Vasileios, additional, Stock, Ulrich, additional, Bowles, Christopher, additional, Dunning, John, additional, and Riesgo Gil, Fernando, additional

Published
2024
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14. Adults living with Duchenne muscular dystrophy: old and new challenges in a cohort of 19 patients in their third to fifth decade

Author

Gadaleta, Giulio, primary, Urbano, Guido, additional, Brusa, Chiara, additional, D'Alessandro, Rossella, additional, Rolle, Enrica, additional, Cavallina, Ilaria, additional, Mattei, Alessio, additional, Ribolla, Fulvia, additional, Raineri, Claudia, additional, Pidello, Stefano, additional, Vercelli, Liliana, additional, Ricci, Federica S., additional, and Mongini, Tiziana E., additional

Published
2023
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15. Transthyretin cardiac amyloidosis in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement: experience of a single center.

Author

GALLONE, Guglielmo, BONGIOVANNI, Chiara, BRUNO, Francesco, LANDRA, Federico, ANDREIS, Alessandro, FAVA, Antonella, SCUDELER, Luca, DE FILIPPO, Ovidio, CALIFARETTI, Elena, CIOFFI, Martina, PIDELLO, Stefano, VAIRO, Alessandro, RAINERI, Claudia, FREA, Simone, GIORGI, Mauro, ALUNNI, Gianluca, CASONI, Roberta, SALIZZONI, Stefano, CONROTTO, Federico, and D’ASCENZO, Fabrizio

Published
2024
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17. Acute Reduction in Left Ventricular Function Following Transcatheter Mitral Edge‐to‐Edge Repair

Author

Perl, Leor, primary, Kheifets, Mark, additional, Guido, Ascione, additional, Agricola, Eustachio, additional, Denti, Paolo, additional, Wild, Mirjam Gauri, additional, Praz, Fabien, additional, Rubbio, Antonio Popolo, additional, Bedogni, Francesco, additional, De Marco, Federico, additional, Beeri, Ronen, additional, Shuvy, Mony, additional, Melillo, Francesco, additional, Montorfano, Matteo, additional, Freixa, Xavier, additional, de la Fuente Mancera, Juan Carlos, additional, Giordano, Arturo, additional, Finizio, Filippo, additional, Van Mieghem, Nicolas M., additional, Ooms, J. F. W., additional, Fam, Neil, additional, O'Connor, Cormac, additional, Toggweiler, Stefan, additional, Levi, Amos, additional, Shapira, Yaron, additional, Schwartzenberg, Shmuel, additional, Pidello, Stefano, additional, D'Ascenzo, Fabrizio, additional, Angelini, Filippo, additional, Haberman, Dan, additional, Crimi, Gabriele, additional, Porto, Italo, additional, Cozzi, Ottavia, additional, Giannini, Francesco, additional, Tarantini, Giuseppe, additional, Maisano, Francesco, additional, Kornowski, Ran, additional, Perl, Leor, additional, Corcione, Nicola, additional, O’Connor, Cormac, additional, D’Ascenzo, Fabrizio, additional, Mangieri, Antonio, additional, Regazzoli, Damiano, additional, Cimaglia, Paolo, additional, Flamigni, Filippo, additional, and Masiero, Giulia, additional

Published
2023
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19. G-CSF for Extensive STEMI: Results From the STEM-AMI OUTCOME CMR Substudy

Author

Achilli, Felice, Pontone, Gianluca, Bassetti, Beatrice, Squadroni, Lidia, Campodonico, Jeness, Corrada, Elena, Facchini, Camilla, Mircoli, Luca, Esposito, Giovanni, Scarpa, Daniele, Pidello, Stefano, Righetti, Stefano, Di Gennaro, Filiberto, Guglielmo, Marco, Muscogiuri, Giuseppe, Baggiano, Andrea, Limido, Alberto, Lenatti, Laura, Di Tano, Giuseppe, Malafronte, Cristina, Soffici, Federica, Ceseri, Martina, Maggiolini, Stefano, Colombo, Gualtiero I., and Pompilio, Giulio

Published
2019
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20. Acute Reduction in Left Ventricular Function Following Transcatheter Mitral Edge-to-Edge Repair

Author

Perl, Leor, Kheifets, Mark, Guido, Ascione, Agricola, Eustachio, Denti, Paolo, Wild, Mirjam Gauri, Praz, Fabien, Rubbio, Antonio Popolo, Bedogni, Francesco, De Marco, Federico, Beeri, Ronen, Shuvy, Mony, Melillo, Francesco, Montorfano, Matteo, Freixa, Xavier, de la Fuente Mancera, Juan Carlos, Giordano, Arturo, Finizio, Filippo, Van Mieghem, Nicolas M., Ooms, J. F.W., Fam, Neil, O’connor, Cormac, Toggweiler, Stefan, Levi, Amos, Shapira, Yaron, Schwartzenberg, Shmuel, Pidello, Stefano, D’ascenzo, Fabrizio, Angelini, Filippo, Haberman, Dan, Crimi, Gabriele, Porto, Italo, Cozzi, Ottavia, Giannini, Francesco, Tarantini, Giuseppe, Maisano, Francesco, Kornowski, Ran, Perl, Leor, Kheifets, Mark, Guido, Ascione, Agricola, Eustachio, Denti, Paolo, Wild, Mirjam Gauri, Praz, Fabien, Rubbio, Antonio Popolo, Bedogni, Francesco, De Marco, Federico, Beeri, Ronen, Shuvy, Mony, Melillo, Francesco, Montorfano, Matteo, Freixa, Xavier, de la Fuente Mancera, Juan Carlos, Giordano, Arturo, Finizio, Filippo, Van Mieghem, Nicolas M., Ooms, J. F.W., Fam, Neil, O’connor, Cormac, Toggweiler, Stefan, Levi, Amos, Shapira, Yaron, Schwartzenberg, Shmuel, Pidello, Stefano, D’ascenzo, Fabrizio, Angelini, Filippo, Haberman, Dan, Crimi, Gabriele, Porto, Italo, Cozzi, Ottavia, Giannini, Francesco, Tarantini, Giuseppe, Maisano, Francesco, and Kornowski, Ran

Abstract

BACKGROUND: Little is known about the impact of transcatheter mitral valve edge-to-edge repair on changes in left ventricular ejection fraction (LVEF) and the effect of an acute reduction in LVEF on prognosis. We aimed to assess changes in LVEF after transcatheter mitral valve edge-to-edge repair for both primary and secondary mitral regurgitation (PMR and SMR, respectively), identify rates and predictors of LVEF reduction, and estimate its impact on prognosis. METHODS AND RESULTS: In this international multicenter registry, patients with both PMR and SMR undergoing transcatheter mitral valve edge-to-edge repair were included. We assessed rates of acute LVEF reduction (LVEFR), defined as an acute relative decrease of >15% in LVEF, its impact on all-cause mortality, major adverse cardiac event (composite end point of all-cause death, mitral valve surgery, and residual mitral regurgitation grade ≥2), and LVEF at 12 months, as well as predictors for LVEFR. Of 2534 patients included (727 with PMR, and 1807 with SMR), 469 (18.5%) developed LVEFR. Patients with PMR were older (79.0±9.2 versus 71.8±8.9 years; P<0.001) and had higher mean LVEF (54.8±14.0% versus 32.7±10.4%; P<0.001) at baseline. After 6 to 12 months (median, 9.9 months; interquartile range, 7.8–11.9 months), LVEF was significantly lower in patients with PMR (53.0% versus 56.0%; P<0.001) but not in patients with SMR. The 1-year mortality was higher in patients with PMR with LVEFR (16.9% versus 9.7%; P<0.001) but not in those with SMR (P=0.236). LVEF at baseline (odds ratio, 1.03 [95% CI, 1.01– 1.05]; P=0.002) was predictive of LVEFR for patients with PMR, but not those with SMR (P=0.092). CONCLUSIONS: Reduction in LVEF is not uncommon after transcatheter mitral valve edge-to-edge repair and is correlated with worsened prognosis in patients with PMR but not patients with SMR. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05311163.

Published
2023

21. Adults living with Duchenne muscular dystrophy: old and new challenges in a cohort of 19 patients in their third to fifth decade.

Author

Gadaleta, Giulio, Urbano, Guido, Brusa, Chiara, D'Alessandro, Rossella, Rolle, Enrica, Cavallina, Ilaria, Mattei, Alessio, Ribolla, Fulvia, Raineri, Claudia, Pidello, Stefano, Vercelli, Liliana, Ricci, Federica S., and Mongini, Tiziana E.

Subjects
DUCHENNE muscular dystrophy, PATIENTS' attitudes, ADULTS, NEUROLOGICAL disorders, EMERGENCY management, ACID-base imbalances
Abstract

Background and purpose: Advances in multidisciplinary care are extending overall survival in Duchenne muscular dystrophy (DMD) patients. Our research objective was to delineate the clinical characteristics of this particular cohort and identify novel challenges associated with the disease. Methods: Nineteen individuals aged 25–48 years (median 34 years) with a confirmed diagnosis of out‐of‐frame DMD gene mutation were selected. Results: All patients were mechanically ventilated (5/19 via tracheostomy), with different patterns of cardiomyopathy. Swallowing and nutritional issues were frequent (median body mass index 18.95), with six cases requiring artificial enteral feeding (median age at start 29 years), as well as bone density alterations (11/19, 58%). Only 2/19 had been on long‐term prednisone therapy. Issues requiring at‐home/hospital assistance were respiratory infections (15/19, 79%), gastroenterological symptoms (9/19, 47%, including toxic megacolon and rectal perforation after repeated enemas), metabolic acidosis (2/19, 11%) and recurrent ischaemic strokes (1/19, 5%). From a social perspective, augmented‐alternative communication devices were necessary for 7/19 (37%), with most of the patients being assisted at home and 2/19 institutionalized. Eight/19 (42%) patients experienced psychiatric symptoms (median age at presentation 16 years) and 9/19 (47%) chronic pain (median age at onset 23 years), in both cases treated with psychoactive/analgesic drugs without major adverse events. The patients' subjective perception of physical health resulted in unfavourable scores, whilst the subjective assessment of mental health unexpectedly showed more positive values compared to other chronic neurological conditions. Conclusions: The analysis of adults living with DMD reveals several new health‐related issues, such as the management of emergencies and safety of pharmacological treatments for psychiatric symptoms, chronic pain management, as well as an increasing caregivers burden. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Meta-Analysis of the Usefulness of Mitraclip in Patients With Functional Mitral Regurgitation

Author

D'ascenzo, Fabrizio, Moretti, Claudio, Marra, Walter Grosso, Montefusco, Antonio, Omede, Pierluigi, Taha, Salma, Castagno, Davide, Gaemperli, Oliver, Taramasso, Maurizio, Frea, Simone, Pidello, Stefano, Rudolph, Volker, Franzen, Olaf, Braun, Daniel, Giannini, Cristina, Ince, Huseyin, Perl, Leor, Zoccai, Giuseppe, Marra, Sebastiano, D'Amico, Maurizio, Maisano, Francesco, Rinaldi, Mauro, and Gaita, Fiorenzo

Published
2015
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28. Outcomes of Transcatheter Edge-to-Edge Repair in Degenerative vs. Functional Mitral Regurgitation

Author

Kheifets, Mark, primary, Angelini, Filippo, additional, D’Ascenzo, Fabrizio, additional, Pidello, Stefano, additional, Engelstein, Haya, additional, Bocchino, Pier Paolo, additional, Boretto, Paolo, additional, Frea, Simone, additional, Levi, Amos, additional, Vaknin-Assa, Hana, additional, Vaturi, Mordehay, additional, Shapira, Yaron, additional, Kornowski, Ran, additional, and Perl, Leor, additional

Published
2022
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29. Evolution of tricuspid regurgitation after transcatheter edge‐to‐edge mitral valve repair for secondary mitral regurgitation and its impact on mortality

Author

Adamo, Marianna, primary, Pagnesi, Matteo, additional, Ghizzoni, Giulia, additional, Estévez‐Loureiro, Rodrigo, additional, Raposeiras‐Roubin, Sergio, additional, Tomasoni, Daniela, additional, Stolfo, Davide, additional, Sinagra, Gianfranco, additional, Popolo Rubbio, Antonio, additional, Bedogni, Francesco, additional, De Marco, Federico, additional, Giannini, Cristina, additional, Petronio, Anna Sonia, additional, Stazzoni, Laura, additional, Benito‐González, Tomás, additional, Fernández‐Vázquez, Felipe, additional, Garrote‐Coloma, Carmen, additional, Godino, Cosmo, additional, Agricola, Eustachio, additional, Munafò, Andrea, additional, Pascual, Isaac, additional, Avanzas, Pablo, additional, Léon, Victor, additional, Montefusco, Antonio, additional, Boretto, Paolo, additional, Pidello, Stefano, additional, Moñivas‐Palomero, Vanessa, additional, Del Trigo, Maria, additional, Biagini, Elena, additional, Berardini, Alessandra, additional, Saia, Francesco, additional, Nombela‐Franco, Luis, additional, Tirado‐Conte, Gabriela, additional, De Augustin, Alberto, additional, Caneiro‐Queija, Berenice, additional, De Luca, Antonio, additional, Branca, Luca, additional, Zaccone, Gregorio, additional, Lupi, Laura, additional, Lipsic, Erik, additional, Voors, Adriaan, additional, and Metra, Marco, additional

Published
2022
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33. Identification of novel circulating microRNAs in advanced heart failure by next‐generation sequencing

Author

Galluzzo, Alessandro, primary, Gallo, Simona, additional, Pardini, Barbara, additional, Birolo, Giovanni, additional, Fariselli, Piero, additional, Boretto, Paolo, additional, Vitacolonna, Annapia, additional, Peraldo‐Neia, Caterina, additional, Spilinga, Martina, additional, Volpe, Alessandra, additional, Celentani, Dario, additional, Pidello, Stefano, additional, Bonzano, Alessandro, additional, Matullo, Giuseppe, additional, Giustetto, Carla, additional, Bergerone, Serena, additional, and Crepaldi, Tiziana, additional

Published
2021
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34. A case series of Novel-Coronavirus infection in heart transplantation from two centers in the pandemic area in the North of Italy

Author

Iacovoni, Attilio, Boffini, Massimo, Pidello, Stefano, Simonato, Erika, Barbero, Cristina, Sebastiani, Roberta, Vittori, Claudia, Fontana, Alessandra, Terzi, Amedeo, De Ferrari, Gaetano Maria, and Rinaldi, Mauro

Subjects
coronavirus, COVID-19, epidemiology, Northern Italy, heart transplantation, COVID_19, coronavirus disease 2019, SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, Article
Published
2020

35. Lateral Thoracotomy Implantation of Left Ventricular Assist Device

Author

Attisani, Matteo, primary, Frea, Simone, additional, Pidello, Stefano, additional, Barbero, Cristina, additional, Lodo, Vittoria, additional, Centofanti, Paolo, additional, Cingolani, Marco M., additional, Aste, Andrea, additional, Recchia, Elisa, additional, Brenna, Dario, additional, De Ferrari, Gaetano M., additional, Rinaldi, Mauro, additional, and Boffini, Massimo, additional

Published
2021
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42. Diuretic treatment in high-risk acute decompensation of advanced chronic heart failure—bolus intermittent vs. continuous infusion of furosemide: a randomized controlled trial

Author

Frea, Simone, primary, Pidello, Stefano, additional, Volpe, Alessandra, additional, Canavosio, Federico Giovanni, additional, Galluzzo, Alessandro, additional, Bovolo, Virginia, additional, Camarda, Antonio, additional, Golzio, Pier Giorgio, additional, D’Ascenzo, Fabrizio, additional, Bergerone, Serena, additional, Rinaldi, Mauro, additional, and Gaita, Fiorenzo, additional

Published
2019
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43. Improving Selection of Mitraclip Candidates in Advanced Chronic Heart Failure: Look Right to Predict Right

Author

Frea, Simone, primary, Crimi, Gabriele, additional, Gaemperli, Oliver, additional, Pidello, Stefano, additional, Raineri, Claudia, additional, D'Ascenzo, Fabrizio, additional, Crescio, Valeria, additional, Boretto, Paolo, additional, Gritti, Valeria, additional, Giordana, Francesca, additional, Magrini, Giulia, additional, Rettegno, Sara, additional, Gazzoli, Fabrizio, additional, Rabajoli, Alessandra, additional, Montefusco, Antonio, additional, Ferrario, Maurizio, additional, La Torre, Michele W, additional, D'Amico, Maurizio, additional, Rinaldi, Mauro, additional, Ruschitzka, Frank, additional, and Oltrona Visconti, Luigi, additional

Published
2019
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44. Extracorporeal membrane oxygenation after lung transplantation: risk factors and outcomes analysis

Author

Boffini, Massimo, primary, Simonato, Erika, additional, Ricci, Davide, additional, Scalini, Fabrizio, additional, Marro, Matteo, additional, Pidello, Stefano, additional, Attisani, Matteo, additional, Solidoro, Paolo, additional, Lausi, Paolo Olivo, additional, Fanelli, Vito, additional, Barbero, Cristina, additional, Brazzi, Luca, additional, and Rinaldi, Mauro, additional

Published
2019
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47. Does asymptomatic recurrent diffuse capillary C4d complement deposition impair cardiac allograft function?

Author

Frea, Simone, primary, Iacovino, Cristina, additional, Botta, Michela, additional, De Filippi, Ilaria, additional, Mazzucco, Gianna, additional, Pidello, Stefano, additional, Biolè, CarloAlberto, additional, Bergerone, Serena, additional, Boffini, Massimo, additional, Praticò Barbato, Loredana, additional, Morello, Mara, additional, Rinaldi, Mauro, additional, and Gaita, Fiorenzo, additional

Published
2016
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50. Evolution of tricuspid regurgitation after transcatheter edge-to-edge mitral valve repair for secondary mitral regurgitation and its impact on mortality

Author

Marianna Adamo, Matteo Pagnesi, Giulia Ghizzoni, Rodrigo Estévez‐Loureiro, Sergio Raposeiras‐Roubin, Daniela Tomasoni, Davide Stolfo, Gianfranco Sinagra, Antonio Popolo Rubbio, Francesco Bedogni, Federico De Marco, Cristina Giannini, Anna Sonia Petronio, Laura Stazzoni, Tomás Benito‐González, Felipe Fernández‐Vázquez, Carmen Garrote‐Coloma, Cosmo Godino, Eustachio Agricola, Andrea Munafò, Isaac Pascual, Pablo Avanzas, Victor Léon, Antonio Montefusco, Paolo Boretto, Stefano Pidello, Vanessa Moñivas‐Palomero, Maria Del Trigo, Elena Biagini, Alessandra Berardini, Francesco Saia, Luis Nombela‐Franco, Gabriela Tirado‐Conte, Alberto De Augustin, Berenice Caneiro‐Queija, Antonio De Luca, Luca Branca, Gregorio Zaccone, Laura Lupi, Erik Lipsic, Adriaan Voors, Marco Metra, Adamo, Marianna, Pagnesi, Matteo, Ghizzoni, Giulia, Estévez-Loureiro, Rodrigo, Raposeiras-Roubin, Sergio, Tomasoni, Daniela, Stolfo, Davide, Sinagra, Gianfranco, Popolo Rubbio, Antonio, Bedogni, Francesco, De Marco, Federico, Giannini, Cristina, Petronio, Anna Sonia, Stazzoni, Laura, Benito-González, Tomá, Fernández-Vázquez, Felipe, Garrote-Coloma, Carmen, Godino, Cosmo, Agricola, Eustachio, Munafò, Andrea, Pascual, Isaac, Avanzas, Pablo, Léon, Victor, Montefusco, Antonio, Boretto, Paolo, Pidello, Stefano, Moñivas-Palomero, Vanessa, Del Trigo, Maria, Biagini, Elena, Berardini, Alessandra, Saia, Francesco, Nombela-Franco, Lui, Tirado-Conte, Gabriela, De Augustin, Alberto, Caneiro-Queija, Berenice, De Luca, Antonio, Branca, Luca, Zaccone, Gregorio, Lupi, Laura, Lipsic, Erik, Voors, Adriaan, Metra, Marco, and Cardiovascular Centre (CVC)

Subjects
Mortality, Transcatheter edge-to-edge mitral valve repair, Tricuspid regurgitation, Heart Failure, OUTCOMES, TRIVALVE, Humans, Mitral Valve, Cardiology and Cardiovascular Medicine, SYSTEM, Retrospective Studies
Abstract

Aim: To evaluate short-term changes in tricuspid regurgitation (TR) after transcatheter edge-to-edge mitral valve repair (M-TEER) in secondary mitral regurgitation (SMR), their predictors and impact on mortality. Methods and results: This is a retrospective analysis of SMR patients undergoing successful M-TEER (post-procedural mitral regurgitation ≤2+) at 13 European centres. Among 503 patients evaluated 79 (interquartile range [IQR] 40-152) days after M-TEER, 173 (35%) showed ≥1 degree of TR improvement, 97 (19%) had worsening of TR, and 233 (46%) remained unchanged. Smaller baseline left atrial diameter and residual mitral regurgitation 0/1+ were independent predictors of TR ≤2+ after M-TEER. There was a significant association between TR changes and New York Heart Association class and pulmonary artery systolic pressure decrease at echocardiographic re-assessment. At a median follow-up of 590 (IQR 209-1103) days from short-term echocardiographic re-assessment, all-cause mortality was lower in patients with improved compared to those with unchanged/worsened TR (29.6% vs. 42.3% at 3 years; log-rank p = 0.034). Baseline TR severity was not associated with mortality, whereas TR 0/1+ and 2+ at short-term follow-up was associated with lower all-cause mortality compared to TR 3/4+ (30.6% and 35.6% vs. 55.6% at 3 years; p < 0.001). A TR ≤2+ after M-TEER was independently associated with a 42% decreased risk of mortality (p = 0.011). Conclusion: More than one third of patients with SMR undergoing successful M-TEER experienced an improvement in TR. Pre-procedural TR was not associated with outcome, but a TR ≤2+ at short-term follow-up was independently associated with long-term mortality. Optimal M-TEER result and a small left atrium were associated with a higher likelihood of TR ≤2+ after M-TEER.

Published
2022

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