Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR
Background: Percutaneous mitral valve repair (PMVR) has evolved to be a standard procedure in suitable patients with mitral regurgitation (MR) not accessible for open surgery. Here, we analyzed the influence of the number and positioning of the clips implanted during the procedure on MR reduction an...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906723000210 |
| _version_ | 1797854550707666944 |
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| author | Reinhard Sauter Chaolan Lin Harry Magunia Juergen Schreieck Daniel Dürschmied Meinrad Gawaz Johannes Patzelt Harald F. Langer |
| author_facet | Reinhard Sauter Chaolan Lin Harry Magunia Juergen Schreieck Daniel Dürschmied Meinrad Gawaz Johannes Patzelt Harald F. Langer |
| author_sort | Reinhard Sauter |
| collection | DOAJ |
| description | Background: Percutaneous mitral valve repair (PMVR) has evolved to be a standard procedure in suitable patients with mitral regurgitation (MR) not accessible for open surgery. Here, we analyzed the influence of the number and positioning of the clips implanted during the procedure on MR reduction analyzing also sub-collectives of functional and degenerative MR (DMR). Results: We included 410 patients with severe MR undergoing PMVR using the MitraClip® System. MR and reduction of MR were analyzed by TEE at the beginning and at the end of the PMVR procedure. To specify the clip localization, we sub-divided segment 2 into 3 sub-segments using the segmental classification of the mitral valve. Results: We found an enhanced reduction of MR predominantly in DMR patients who received more than one clip. Implantation of only one clip led to a higher MR reduction in patients with functional MR (FMR) in comparison to patients with DMR. No significant differences concerning pressure gradients could be observed in degenerative MR patients regardless of the number of clips implanted. A deterioration of half a grade of the achieved MR reduction was observed 6 months post-PMVR independent of the number of implanted clips with a better stability in FMR patients, who got 3 clips compared to patients with only one clip. Conclusions: In patients with FMR, after 6 months the reduction of MR was more stable with an increased number of implanted clips, which suggests that this specific patient collective may benefit from a higher number of clips. |
| first_indexed | 2024-04-09T20:07:52Z |
| format | Article |
| id | doaj.art-a71e3768d6514027906df90a59cd93c1 |
| institution | Directory Open Access Journal |
| issn | 2352-9067 |
| language | English |
| last_indexed | 2024-04-09T20:07:52Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj.art-a71e3768d6514027906df90a59cd93c12023-04-01T08:50:23ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672023-04-0145101190Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MRReinhard Sauter0Chaolan Lin1Harry Magunia2Juergen Schreieck3Daniel Dürschmied4Meinrad Gawaz5Johannes Patzelt6Harald F. Langer7Cardiology, Medical Intensive Care, Angiology and Haemostaseology, University Medical Centre Mannheim, Mannheim, Germany; University Hospital, Department of Cardiology, Eberhard Karls University Tuebingen, Tuebingen, GermanyUniversity Hospital, Department of Cardiology, Eberhard Karls University Tuebingen, Tuebingen, GermanyUniversity Hospital, Department of Anaesthesiology, Eberhard Karls University Tuebingen, Tuebingen, GermanyUniversity Hospital, Department of Anaesthesiology, Eberhard Karls University Tuebingen, Tuebingen, GermanyCardiology, Medical Intensive Care, Angiology and Haemostaseology, University Medical Centre Mannheim, Mannheim, Germany; DZHK (German Research Centre for Cardiovascular Research), Partner Site Mannheim/Heidelberg, GermanyUniversity Hospital, Department of Cardiology, Eberhard Karls University Tuebingen, Tuebingen, GermanyUniversity Hospital, Department of Cardiology, Eberhard Karls University Tuebingen, Tuebingen, GermanyCardiology, Medical Intensive Care, Angiology and Haemostaseology, University Medical Centre Mannheim, Mannheim, Germany; DZHK (German Research Centre for Cardiovascular Research), Partner Site Mannheim/Heidelberg, Germany; Corresponding author at: Cardiology, Medical Intensive Care, Angiology and Haemostaseology, University Medical Centre Mannheim, 68167 Mannheim, Germany.Background: Percutaneous mitral valve repair (PMVR) has evolved to be a standard procedure in suitable patients with mitral regurgitation (MR) not accessible for open surgery. Here, we analyzed the influence of the number and positioning of the clips implanted during the procedure on MR reduction analyzing also sub-collectives of functional and degenerative MR (DMR). Results: We included 410 patients with severe MR undergoing PMVR using the MitraClip® System. MR and reduction of MR were analyzed by TEE at the beginning and at the end of the PMVR procedure. To specify the clip localization, we sub-divided segment 2 into 3 sub-segments using the segmental classification of the mitral valve. Results: We found an enhanced reduction of MR predominantly in DMR patients who received more than one clip. Implantation of only one clip led to a higher MR reduction in patients with functional MR (FMR) in comparison to patients with DMR. No significant differences concerning pressure gradients could be observed in degenerative MR patients regardless of the number of clips implanted. A deterioration of half a grade of the achieved MR reduction was observed 6 months post-PMVR independent of the number of implanted clips with a better stability in FMR patients, who got 3 clips compared to patients with only one clip. Conclusions: In patients with FMR, after 6 months the reduction of MR was more stable with an increased number of implanted clips, which suggests that this specific patient collective may benefit from a higher number of clips.http://www.sciencedirect.com/science/article/pii/S2352906723000210Mitral regurgitationStructural heart diseaseInterventional therapySurgeryPMVRHeart geometry |
| spellingShingle | Reinhard Sauter Chaolan Lin Harry Magunia Juergen Schreieck Daniel Dürschmied Meinrad Gawaz Johannes Patzelt Harald F. Langer Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR International Journal of Cardiology: Heart & Vasculature Mitral regurgitation Structural heart disease Interventional therapy Surgery PMVR Heart geometry |
| title | Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR |
| title_full | Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR |
| title_fullStr | Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR |
| title_full_unstemmed | Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR |
| title_short | Improved mid-term stability of MR reduction with an increased number of clips after percutaneous mitral valve repair in functional MR |
| title_sort | improved mid term stability of mr reduction with an increased number of clips after percutaneous mitral valve repair in functional mr |
| topic | Mitral regurgitation Structural heart disease Interventional therapy Surgery PMVR Heart geometry |
| url | http://www.sciencedirect.com/science/article/pii/S2352906723000210 |
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