Back to Search
Start Over
Impact of effective regurgitant orifice area on outcome of secondary mitral regurgitation transcatheter repair.
- Source :
-
Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2021 May; Vol. 110 (5), pp. 732-739. Date of Electronic Publication: 2021 Mar 04. - Publication Year :
- 2021
-
Abstract
- Objectives: To assess the value of effective regurgitant orifice (ERO) in predicting outcome after edge-to-edge transcatheter mitral valve repair (TMVR) for secondary mitral regurgitation (SMR) and identify the optimal cut-off for patients' selection.<br />Methods: Using the EuroSMR (European Registry of Transcatheter Repair for Secondary Mitral Regurgitation) registry, that included patients undergoing edge-to-edge TMVR for SMR between November 2008 and January 2019 in 8 experienced European centres, we assessed the optimal ERO threshold associated with mortality in SMR patients undergoing TMVR, and compared characteristics and outcomes of patients according to baseline ERO.<br />Results: Among 1062 patients with severe SMR and ERO quantification by proximal isovelocity surface area method in the registry, ERO was < 0.3 cm <superscript>2</superscript> in 575 patients (54.1%), who were more symptomatic at baseline (NYHA class ≥ III: 91.4% vs. 86.9%, for ERO < vs. ≥ 0.3 cm <superscript>2</superscript> ; P = 0.004). There was no difference in all-cause mortality at 2-year follow-up according to baseline ERO (28.3% vs. 30.0% for ERO < vs. ≥ 0.3 cm <superscript>2</superscript> , P = 0.585). Both patient groups demonstrated significant improvement of at least one NYHA class (61.7% and 73.8%, P = 0.002), resulting in a prevalence of NYHA class ≤ II at 1-year follow-up of 60.0% and 67.4% for ERO < vs. ≥ 0.3 cm <superscript>2</superscript> , respectively (P = 0.05).<br />Conclusion: All-cause mortality at 2 years after TMVR does not differ if baseline ERO is < or ≥ 0.3 cm <superscript>2</superscript> , and both groups exhibit relevant clinical improvements. Accordingly, TMVR should not be withheld from patients with ERO < 0.3 cm <superscript>2</superscript> who remain symptomatic despite optimal medical treatment, if TMVR appropriateness was determined by experienced teams in dedicated valve centres.
- Subjects :
- Aged
Aged, 80 and over
Cohort Studies
Female
Follow-Up Studies
Humans
Male
Mortality
Prognosis
Registries
Retrospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Cardiac Catheterization methods
Heart Valve Prosthesis Implantation methods
Mitral Valve Insufficiency surgery
Patient Selection
Subjects
Details
- Language :
- English
- ISSN :
- 1861-0692
- Volume :
- 110
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical research in cardiology : official journal of the German Cardiac Society
- Publication Type :
- Academic Journal
- Accession number :
- 33661372
- Full Text :
- https://doi.org/10.1007/s00392-021-01807-0