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Long-Term Survival Following Transcatheter Mitral Valve Repair: Pooled Analysis of Prospective Trials with the Carillon Device.
- Source :
-
Cardiovascular Revascularization Medicine . Jun2020, Vol. 21 Issue 6, p712-716. 5p. - Publication Year :
- 2020
-
Abstract
- <bold>Purpose: </bold>To report long-term survival and to identify potential determinants of survival among patients receiving treatment for functional mitral regurgitation (FMR) with the Carillon device.<bold>Methods: </bold>This was a post hoc analysis in which we pooled prospectively collected data from three studies of the Carillon device with available long-term vital status data. Patient eligibility in these trials specified symptomatic congestive heart failure despite guideline-directed medical therapy, grade 2 to 4 FMR, left ventricular enlargement, and reduced ejection fraction. Echocardiographic parameters were available through the 12-month visit and vital status was available through 5 years. The association of patient characteristics and changes in echocardiographic parameters at 6 and 12 months with long-term survival was analyzed using Cox proportional hazards regression.<bold>Results: </bold>A total of 74 patients (mean age 67 years, 72% male, 59% MR grade 3 or 4) were treated with the Carillon device. Over 1 year of follow-up, the New York Heart Association (NYHA) class decreased in 64% of patients, distance on the 6-minute walk test increased, and echocardiographic measures indicated significant decreases in MR grade and favorable left ventricular remodeling. The Kaplan-Meier survival rate was 83.6% at 1 year, 73.1% at 2 years, 67.9% at 3 years, and 56.2% at 4 and 5 years of follow-up. Primary determinants of long-term survival were a decrease in NYHA class, an increase in 6-minute walk test distance, and a decrease in regurgitant volume during the first year of follow-up.<bold>Conclusions: </bold>Among patients with congestive heart failure and grade 2 to 4 FMR who were symptomatic despite guideline-directed medical therapy, transcatheter mitral valve repair with the Carillon device resulted in a favorable 5-year survival rate. The survival benefit was greatest among patients with improvement in clinical and hemodynamic parameters during the first year of follow-up. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MITRAL valve
*VENTRICULAR ejection fraction
*CONGESTIVE heart failure
*MITRAL valve insufficiency
*HEART failure patients
*VENTRICULAR remodeling
*MITRAL valve surgery
*PROSTHETICS
*CLINICAL trials
*CONVALESCENCE
*TIME
*RISK assessment
*TREATMENT effectiveness
*PROSTHETIC heart valves
*HEMODYNAMICS
*LONGITUDINAL method
*EQUIPMENT & supplies
Subjects
Details
- Language :
- English
- ISSN :
- 15538389
- Volume :
- 21
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Cardiovascular Revascularization Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 144990964
- Full Text :
- https://doi.org/10.1016/j.carrev.2020.02.012