Levosimendan as an adjunctive therapy to MitraClip implantation in patients with severe mitral regurgitation and left ventricular dysfunction

Freixa, Xavier; Hernández, Manuel Cruz; Farrero, Marta; Sitges, Marta; Jiménez, Gustavo Guerrero; Regueiro, Ander; Fita, G.; Tatjer, I.; Andrea, Rut; Martín-Yuste, Victoria; Brugaletta, Salvatore; Masotti, Mónica; Sabaté, Manel

doi:10.1016/j.ijcard.2015.09.056

Cited by 14 publications

(14 citation statements)

References 8 publications

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“…In this setting, the administration of levosimendan 0.01 μg/kg/min before, during and after the procedure might help to reduce the risk of acute hemodynamic worsening following percutaneous functional MR correction (54).…”

Section: Introductionmentioning

confidence: 99%

Complications Following Percutaneous Mitral Valve Repair

Gheorghe

Ielasi

Rensing

et al. 2019

Front. Cardiovasc. Med.

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Mitral valve disease affects more than 4 million people in the United States and it is the second most prevalent valvulopathy in Europe. The gold standard of treatment in these patients is surgical repair or mitral valve replacement. In the last decade, numerous transcatheter therapies have been developed to overcome the increased number of subjects with symptomatic severe mitral regurgitation and high surgical risk. The Mitraclip (Abbott Vascular, Menlo Park, CA), PASCAL (Edwards Lifesciences, Irvine, CA, USA), the Carillon™ Mitral Contour System™ (Cardiac Dimension Inc., Kirkland, WA, USA), the Mitralign™ (Mitralign, Tewksbury, Massachusetts), and the Cardioband (Edwards Lifesciences, Irvine, CA) are the principal percutaneous devices for mitral valve repair. We present an evidence-based clinical update that provides an overview of these technologies and their potential complications.

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Section: Introductionmentioning

confidence: 99%

Complications Following Percutaneous Mitral Valve Repair

Gheorghe

Ielasi

Rensing

et al. 2019

Front. Cardiovasc. Med.

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“…The cardio‐depressant effects of intravenous anesthetic agents relate rather to reduction of the preload and afterload, than to a reduction of left ventricular contractility . Different treatment attempts have been described to address acute left ventricular impairment during MitraClip . This includes the comparison of different anesthetic agents during general anesthesia, or the use of different pharmacological agents during the procedure like dobutamin or levosimendan with overall promising results.…”

Section: Discussionmentioning

confidence: 99%

Intra‐aortic balloon counterpulsation pump in heart failure patients during MitraClip implantation—A propensity‐score matched analysis

Keßler

Seeger

Wöhrle

et al. 2018

Cathet Cardio Intervent

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Objectives: To analyze 30-day and 6-month results after percutaneous mitral valve repair using an IABP as circulatory support.Background: The use of intra-aortic balloon counterpulsation pump extended the spectrum of cardiovascular interventions.Methods: Since 2014, 17 patients of 365 patients (4.7%) at our center received an IABP during MitraClip implantation procedure. We compare the periprocedural results to a control group of 17 patients treated with MitraClip without an IABP support. To adjust for differences of baseline characteristics a propensity-score matching for age, baseline blood pressure, preoperative EuroSCORE II and left ventricular ejection fraction was performed. The decision for prophylactic implantation of an IABP was at the discretion of the interventionalist. For both groups, clinical results up to 6 months were evaluated.Results: The IABP group had higher NT-pro BNP levels at baseline and increased left ventricular diameters. The procedure was more often categorized as "urgent" due to refractory heart failure in the IABP group. All procedures were carried out successfully, thereby achieving a sufficient MR reduction in both groups. Length of hospital stay was significantly longer in the IABP group 11.7 AE 14 days (compared to 6.5 AE 2.9 days in the No IABP group, P < 0.01). All patients in both groups had an event-free 30-day follow-up. MACCE rate was higher in the IABP group compared to the No IABP group (47.1% vs. 23.5%, P = 0.14).Conclusion: Insertion of an IABP during MitraClip procedure might be a feasible option to achieve comparable results and may provide additional safety and procedural hemodynamic stability in the setting of high-risk percutaneous mitral valve repair. K E Y W O R D SHeart failure, IABP, MitraClip

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“…[1][2][3][4][5][6][7] Improved outcomes have been associated with MitraClip use for MR therapy; however, associated hemodynamic changes with the improvement of MR can impart increased work on the left ventricle (LV). 1,[8][9][10] This acute excessive work on a chronically dysfunctional LV can cause cardiovascular deterioration postdeployment. 1,[8][9][10] The expedient diagnosis and treatment of MitraClip-induced acute low cardiac output syndrome, described as afterload mismatch, which can mimic acute mitral stenosis (MS) echocardiographically, may improve patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…1,[8][9][10] This acute excessive work on a chronically dysfunctional LV can cause cardiovascular deterioration postdeployment. 1,[8][9][10] The expedient diagnosis and treatment of MitraClip-induced acute low cardiac output syndrome, described as afterload mismatch, which can mimic acute mitral stenosis (MS) echocardiographically, may improve patient outcomes. 1,[8][9][10] The authors present a case of acute hypotension after MitraClip implantation due to acute LV failure.…”

Section: Introductionmentioning

confidence: 99%

“…1,[8][9][10] The expedient diagnosis and treatment of MitraClip-induced acute low cardiac output syndrome, described as afterload mismatch, which can mimic acute mitral stenosis (MS) echocardiographically, may improve patient outcomes. 1,[8][9][10] The authors present a case of acute hypotension after MitraClip implantation due to acute LV failure. The timely and accurate diagnosis of afterload mismatch resulted in rapid hemodynamic correction and successful care of the patient.…”

Section: Introductionmentioning

confidence: 99%

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Acute Hypotension After MitraClip Implantation due to Acute Left Ventricular Failure

Dalia

Essandoh

2017

Semin Cardiothorac Vasc Anesth

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The MitraClip is a percutaneously implanted device approved for the treatment of symptomatic organic mitral regurgitation in poor surgical candidates. Despite its proven efficacy and safety for mitral regurgitation treatment, the MitraClip may unmask the true afterload of the left ventricle by removing the low-pressure left atrial system and may cause acute left ventricular systolic failure (afterload mismatch). Rapid diagnosis and treatment of afterload mismatch is crucial to ensure optimal patient outcomes. The authors present a case of acute hemodynamic deterioration after MitraClip implantation in a patient with chronic severe left ventricular systolic dysfunction. Transesophageal echocardiography was pivotal for the rapid recognition of acute left ventricular failure and aided in the intraoperative decision-making process and therapy.

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Levosimendan as an adjunctive therapy to MitraClip implantation in patients with severe mitral regurgitation and left ventricular dysfunction

Cited by 14 publications

References 8 publications

Complications Following Percutaneous Mitral Valve Repair

Complications Following Percutaneous Mitral Valve Repair

Intra‐aortic balloon counterpulsation pump in heart failure patients during MitraClip implantation—A propensity‐score matched analysis

Acute Hypotension After MitraClip Implantation due to Acute Left Ventricular Failure

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