Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure
The role of percutaneous mitral valve repair (PMVr) in management of high-risk patients with severe mitral regurgitation (MR) and acute decompensated heart failure (ADHF) is undetermined. We screened all patients who underwent PMVr between October 2015 and March 2020. We evaluated immediate, 30-day,...
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| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/24/5849 |
| _version_ | 1797503470845034496 |
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| author | Anna Turyan Medvedovsky Dan Haberman Mahsati Ibrahimli Ivaylo Tonchev Yonatan Rashi Alona Peretz Sara Shimoni Ortal Tuvali Haim Danenberg Ronen Beeri Mony Shuvy |
| author_facet | Anna Turyan Medvedovsky Dan Haberman Mahsati Ibrahimli Ivaylo Tonchev Yonatan Rashi Alona Peretz Sara Shimoni Ortal Tuvali Haim Danenberg Ronen Beeri Mony Shuvy |
| author_sort | Anna Turyan Medvedovsky |
| collection | DOAJ |
| description | The role of percutaneous mitral valve repair (PMVr) in management of high-risk patients with severe mitral regurgitation (MR) and acute decompensated heart failure (ADHF) is undetermined. We screened all patients who underwent PMVr between October 2015 and March 2020. We evaluated immediate, 30-day, and 1-year outcomes in patients who underwent PMVr during hospitalization due to ADHF as compared to elective patients. From a cohort of 237 patients, we identified 46 patients (19.4%) with severe MR of either functional or degenerative etiology who underwent PMVr during index hospitalization due to ADHF, including 17 (37%) critically ill patients. Patients’ mean age was 75.2 ± 9.8 years, 56% were males. There were no differences in background history between ADHF and elective patients. Patients with ADHF were at higher risk for surgery, reflected in higher mean EuroSCORE II, compared with elective patients. After PMVr, we observed higher 30-day mortality rate in ADHF patients as compared to the elective group (10.9% vs. 3.1%, respectively, <i>p</i> = 0.042). One-year mortality rate was similar between the groups (21.7% vs. 17.9%, <i>p</i> = 0.493). Clinical and echocardiographic follow-up showed improvement of NYHA functional class and sPAP reduction in both groups ((54 ± 15 mmHg to 50 ±15 in the elective group (<i>p</i> = 0.02), 58 ± 13 mmHg to 52 ± 12 in the ADHF group (<i>p</i> = 0.02)). PMVr could be an alternative option for treatment of patients with severe MR and ADHF. |
| first_indexed | 2024-03-10T03:51:09Z |
| format | Article |
| id | doaj.art-cf1d45363c5d4784ac7aea52c68eb3d2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:51:09Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-cf1d45363c5d4784ac7aea52c68eb3d22023-11-23T08:57:08ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-011024584910.3390/jcm10245849Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart FailureAnna Turyan Medvedovsky0Dan Haberman1Mahsati Ibrahimli2Ivaylo Tonchev3Yonatan Rashi4Alona Peretz5Sara Shimoni6Ortal Tuvali7Haim Danenberg8Ronen Beeri9Mony Shuvy10The Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Shmu’el Bait St. 12, Jerusalem 9103102, IsraelKaplan Heart Center, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Pasternak St. P.O. Box 1, Rehovot 76100, IsraelHeart Institute, Hadassah-Hebrew University Medical Center, Jerusalem 90000, IsraelHeart Institute, Hadassah-Hebrew University Medical Center, Jerusalem 90000, IsraelThe Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Shmu’el Bait St. 12, Jerusalem 9103102, IsraelHeart Institute, Hadassah-Hebrew University Medical Center, Jerusalem 90000, IsraelKaplan Heart Center, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Pasternak St. P.O. Box 1, Rehovot 76100, IsraelKaplan Heart Center, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Pasternak St. P.O. Box 1, Rehovot 76100, IsraelHeart Institute, Wolfson Medical Center, Ha-Lokhamim St. 62, Holon 5822012, IsraelHeart Institute, Hadassah-Hebrew University Medical Center, Jerusalem 90000, IsraelThe Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Shmu’el Bait St. 12, Jerusalem 9103102, IsraelThe role of percutaneous mitral valve repair (PMVr) in management of high-risk patients with severe mitral regurgitation (MR) and acute decompensated heart failure (ADHF) is undetermined. We screened all patients who underwent PMVr between October 2015 and March 2020. We evaluated immediate, 30-day, and 1-year outcomes in patients who underwent PMVr during hospitalization due to ADHF as compared to elective patients. From a cohort of 237 patients, we identified 46 patients (19.4%) with severe MR of either functional or degenerative etiology who underwent PMVr during index hospitalization due to ADHF, including 17 (37%) critically ill patients. Patients’ mean age was 75.2 ± 9.8 years, 56% were males. There were no differences in background history between ADHF and elective patients. Patients with ADHF were at higher risk for surgery, reflected in higher mean EuroSCORE II, compared with elective patients. After PMVr, we observed higher 30-day mortality rate in ADHF patients as compared to the elective group (10.9% vs. 3.1%, respectively, <i>p</i> = 0.042). One-year mortality rate was similar between the groups (21.7% vs. 17.9%, <i>p</i> = 0.493). Clinical and echocardiographic follow-up showed improvement of NYHA functional class and sPAP reduction in both groups ((54 ± 15 mmHg to 50 ±15 in the elective group (<i>p</i> = 0.02), 58 ± 13 mmHg to 52 ± 12 in the ADHF group (<i>p</i> = 0.02)). PMVr could be an alternative option for treatment of patients with severe MR and ADHF.https://www.mdpi.com/2077-0383/10/24/5849mitral regurgitationacute decompensated heart failurepercutaneous mitral valve intervention |
| spellingShingle | Anna Turyan Medvedovsky Dan Haberman Mahsati Ibrahimli Ivaylo Tonchev Yonatan Rashi Alona Peretz Sara Shimoni Ortal Tuvali Haim Danenberg Ronen Beeri Mony Shuvy Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure Journal of Clinical Medicine mitral regurgitation acute decompensated heart failure percutaneous mitral valve intervention |
| title | Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure |
| title_full | Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure |
| title_fullStr | Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure |
| title_full_unstemmed | Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure |
| title_short | Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure |
| title_sort | percutaneous mitral valve repair in patients with severe mitral regurgitation and acute decompensated heart failure |
| topic | mitral regurgitation acute decompensated heart failure percutaneous mitral valve intervention |
| url | https://www.mdpi.com/2077-0383/10/24/5849 |
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