TY - JOUR
T1 - Previous TAVR in patients undergoing percutaneous edge-to-edge mitral valve repair (PMVR) affects improvement of MR
AU - Patzelt, Johannes
AU - Ulrich, Miriam
AU - Becker, Annika
AU - Müller, Karin A.L.
AU - Jorbenadze, Rezo
AU - Droppa, Michal
AU - Zhang, Wenzhong
AU - Mandel, Sarah
AU - Habel, Lisa
AU - Lausberg, Henning
AU - Pöss, Janine
AU - Geisler, Tobias
AU - Borst, Oliver
AU - Rosenberger, Peter
AU - Schlensak, Christian
AU - Gawaz, Meinrad
AU - Schreieck, Jürgen
AU - Seizer, Peter
AU - Langer, Harald F.
N1 - Publisher Copyright:
© 2018 Patzelt et al.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/10
Y1 - 2018/10
N2 - Background Patients after transcatheter aortic valve replacement (TAVR) and persistent severe mitral regurgitation (MR) are increasingly treated with percutaneous edge-to-edge mitral valve repair (PMVR). The impact of a former TAVR on PMVR procedures is not clear. Methods and results We retrospectively analyzed 332 patients undergoing PMVR using the MitraClip system with respect to procedural and clinical outcome. 21 of these 332 patients underwent TAVR before PMVR. Intra-procedural transthoracic (TTE) and transesophageal echocardiograms (TEE) immediately before and after clip implantation as well as invasive hemodynamic measurements were evaluated. At baseline, we found a significantly smaller mitral valve anterior- posterior diameter in the TAVR cohort (p < 0.001). A reduction of MR by at least three grades was achieved in a smaller fraction in the TAVR cohort as compared to the cohort with a native aortic valve (p = 0.02). Accordingly, we observed a smaller post-procedural cardiac output in the TAVR cohort (p = 0.02). Conclusion PMVR in patients who had a TAVR before, is associated with altered MR anatomy before and a reduced improvement of MR after the procedure. Future larger and prospective studies will have to determine, whether a previous TAVR influences long-term clinical outcome of patients undergoing PMVR.
AB - Background Patients after transcatheter aortic valve replacement (TAVR) and persistent severe mitral regurgitation (MR) are increasingly treated with percutaneous edge-to-edge mitral valve repair (PMVR). The impact of a former TAVR on PMVR procedures is not clear. Methods and results We retrospectively analyzed 332 patients undergoing PMVR using the MitraClip system with respect to procedural and clinical outcome. 21 of these 332 patients underwent TAVR before PMVR. Intra-procedural transthoracic (TTE) and transesophageal echocardiograms (TEE) immediately before and after clip implantation as well as invasive hemodynamic measurements were evaluated. At baseline, we found a significantly smaller mitral valve anterior- posterior diameter in the TAVR cohort (p < 0.001). A reduction of MR by at least three grades was achieved in a smaller fraction in the TAVR cohort as compared to the cohort with a native aortic valve (p = 0.02). Accordingly, we observed a smaller post-procedural cardiac output in the TAVR cohort (p = 0.02). Conclusion PMVR in patients who had a TAVR before, is associated with altered MR anatomy before and a reduced improvement of MR after the procedure. Future larger and prospective studies will have to determine, whether a previous TAVR influences long-term clinical outcome of patients undergoing PMVR.
UR - http://www.scopus.com/inward/record.url?scp=85055078238&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0205930
DO - 10.1371/journal.pone.0205930
M3 - Journal articles
C2 - 30339701
AN - SCOPUS:85055078238
VL - 13
JO - PLoS ONE
JF - PLoS ONE
IS - 10
M1 - e0205930
ER -
