MitraClip in secondary mitral regurgitation as a bridge to heart transplantation: 1-year outcomes from the International MitraBridge Registry

Godino, Cosmo; Munafò, Andrea; Scotti, Andrea; Estévez‐Loureiro, Rodrigo; Hernández, Antonio Portolés; Arzamendi, Dabit; Peregrina, Estefanía Fernández; Taramasso, Maurizio; Fam, Neil; Ho, Edwin; Asgar, Anita W.; Vitrella, Giancarlo; Raineri, Claudia; Adamo, Marianna; Fiorina, Claudia; Montalto, Claudio; Fraccaro, Chiara; Giannini, Cristina; Fiorelli, Francesca; Rubbio, Antonio Popolo; Ooms, Joris F.; Compagnone, Miriam; Maffeo, Diego; Bettari, Luca; Fürholz, Monika; Tamburino, Corrado; Petronio, Anna Sonia; Grasso, Carmelo; Agricola, Eustachio; Mieghem, Nicolás M. Van; Tarantini, Giuseppe; Curello, Salvatore; Praz, Fabien; Pascual, Isaac; Potena, Luciano; Colombo, Antonio; Maisano, Francesco; Metra, Marco; Margonato, Alberto; Crimi, Gabriele; Saia, Francesco

doi:10.1016/j.healun.2020.09.005

Cited by 89 publications

(50 citation statements)

References 23 publications

(14 reference statements)

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“…Thus, patient selection should be carefully considered in the context of a Heart Team discussion and individualized to avoid performing futile procedures. Consideration of PMVr as a bridge to heart transplantation or definitive ventricular assist device may also be a reasonable option in certain clinical scenarios 65 …”

Section: Discussionmentioning

confidence: 99%

Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review

Martínez-Gómez

McInerney

Tirado‐Conte

et al. 2021

Catheter Cardiovasc Interv

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Background Very few data exist on percutaneous mitral valve repair (PMVr) in unstable patients with concomitant moderate–severe mitral regurgitation (MR). The purpose of this systematic review was to evaluate baseline characteristics, management and clinical outcomes of critically ill patients undergoing PMVr with MitraClip. Methods We conducted a systematic review of the published data on MitraClip from its first use in 2003 to December 2020. Studies referring to critically ill patients in cardiogenic shock or acute refractory pulmonary edema were included. A total of 40 publications including 254 patients with significant MR (Grade 4 in 91%) were included. Results Mean age was 70 ± 12 years with mean Euroscore II and STS of 21 ± 13 and 20.5 ± 16, respectively. Clinical presentation was with cardiogenic shock and acute myocardial infarction in 72.8 and 60.0% of patients, respectively. Device success was achieved in 238 (93.7%) patients with a significant reduction in MR (Grade ≤ 2 in 91.8%, p < .001). The median weaning time from the procedure, to discontinuation of mechanical circulatory or respiratory support, was 2 days (IQR 1–4), with an in‐hospital mortality and non‐fatal complication rate of 12.6 and 9.1%, respectively. Kaplan–Meier curves estimated an overall mortality rate of 39.1% at 12‐month follow‐up, with persistent reduction in MR severity for survivors (Grade ≤ 2 in 81.3%) and one case of mitral valve reintervention. Conclusions Percutaneous mitral valve repair with MitraClip device is a technically feasible and potentially viable management option in high‐risk patients with cardiogenic shock or refractory pulmonary edema and concomitant moderate–severe MR. Prospective trials are required to confirm these findings, and definitively determine the value of MitraClip in hemodynamically unstable patients.

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Section: Discussionmentioning

confidence: 99%

Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review

Martínez-Gómez

McInerney

Tirado‐Conte

et al. 2021

Catheter Cardiovasc Interv

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“…Optimal timing is crucial to obtain the best results in terms of survival and symptomatic benefit. However, a recent international registry has proved that TMVR may extend its therapeutic window even to patients affected by advanced heart failure [14] . This end-stage population can benefit the most from hemodynamic stabilization, symptomatic relief, and recovery from pulmonary hypertension.…”

Section: Secondary Mitral Regurgitation (Smr)mentioning

confidence: 99%

“…While evidence on the use of TMVR for advanced HF is being published [13,14] , whether TMVRpl may play a role in this setting has yet to be proved. Complete and more reproducible reductions in MR may allow for an uptitration of heart failure medical therapies, and this gain could lead to even greater clinical benefits.…”

Section: Future Perspectivesmentioning

confidence: 99%

Patient selection for trans-catheter mitral valve repair versus replacement: ongoing indications and glimpse to the future

Scotti¹,

Galasso²,

Margonato³

et al. 2021

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Transcatheter therapies for patients with severe mitral regurgitation are increasingly performed in recent years. While transcatheter mitral valve repair (TMVR) is now a consolidated intervention with > 100,000 procedures performed worldwide, TMV replacement (TMVRpl) is in its early stages and can only be offered by a few centers. The complexity of mitral valve anatomy requires careful evaluation when selecting the best approach and the most suitable device. At present, the clinical experience with TMVRpl is still in a preliminary phase. Most of the patients treated with this approach thus far are high-risk candidates who have undergone a very restrictive clinical and anatomical selection. Therefore, it is difficult to correctly define which patients might benefit more from TMVRpl than from TMVR. We review the clinical, pathophysiological, and technical factors to suggest when to prefer TMVR instead of a replacement technique.

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“…The authors believe these results show the MitraClip to be safe and effective in this patient population, thereby potentially expanding the MitraClip’s use in heart failure patients. 30…”

Section: Heart Transplantationmentioning

confidence: 99%

The Year 2020 in Review: Noteworthy Literature for Thoracic Transplant Anesthesiologists

Abrams

Wilkey

2021

Semin Cardiothorac Vasc Anesth

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The year 2020 was a monumental year in medicine, and this review focuses on selected articles for cardiothoracic anesthesiologists and perioperative physicians involved in the care of heart and lung transplant patients. In the field of lung transplantation, significant strides were made in our knowledge of risk stratification during the preoperative assessment of potential recipients, perioperative transfusion medicine, and the administration of coagulation factor concentrates. In addition, variations in perioperative management and outcomes between institutions were studied across an assortment of metrics regarding lung transplantation, including case volumes and anesthetic practices. Transitioning to topics in the field of heart transplantation, consideration was given to recipients with adult congenital heart disease, and separately, approaches to expanding the donor pool through donation after circulatory death. With regard to preoperative support, outcomes for the total artificial heart as well as the MitraClip as bridges to transplantation were published.

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MitraClip in secondary mitral regurgitation as a bridge to heart transplantation: 1-year outcomes from the International MitraBridge Registry

Cited by 89 publications

References 23 publications

Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review

Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review

Patient selection for trans-catheter mitral valve repair versus replacement: ongoing indications and glimpse to the future

The Year 2020 in Review: Noteworthy Literature for Thoracic Transplant Anesthesiologists

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