Predictors for long‐term survival after transcatheter edge‐to‐edge mitral valve repair

Abstract

This study determines predictors of long-term clinical outcome after TMVR and demonstrates that the grade of residual MR determines long-term survival. Our data suggest that it might be of benefit reducing residual MR to the lowest possible MR grade using TMVR-especially in selected high-risk patients with primary MR who are not considered as candidates for surgical MVR.

The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation

“…. Previous publications have also reported an association between higher grades of rMR (>2+) after MitraClip therapy and inferior survival rates without specifically focusing on rMR≤1+ as an independent factor for survival, 11,12,[35][36][37] despite the fact that rMR≤2+ was considered as procedural success in previous Mitra-Clip studies. 7 In the present study, Cox regression analyses suggest that rMR ≤ 1+ at discharge is an independent predictor for better long-term survival.…”

Predictors for procedural success and all-cause mortality in patients undergoing transcatheter mitral valve edge-to-edge repair for mitral regurgitation

“…PMR and SMR are two pathophysiologically different entities of mitral valve disease which both lead to similar clinical signs and symptoms. We believe that based on vast differences in baseline clinical characteristics, cardiac anatomy and function, baseline procedural risk before TMVr, and outcome after TMVr, patients with SMR and PMR should be analyzed separately [25] . This viewpoint is supported by an increasing body of evidence.…”

“…One of the main predictors for all-cause mortality in patients with MR undergoing TMVr is impairment of left ventricular function, represented by reduced LV-EF. Several analyses identified impaired LV-EF as highly predictive for five-year [28,35] and long-term mortality [25,42,43] [ Table 1]. Surprisingly, left ventricular size and geometry do not seem to play a major role in predicting TMVr all-cause mortality when including both SMR and PMR patients into multivariable models.…”

MitraClip in patients with functional mitral regurgitation and advanced heart failure - Single centre experience

“…Omezením zpětného toku krve do levé síně a plicního řečiště se zmenšuje plicní městnání, na druhou stranu se zvyšuje afterload LK, a tedy i systolické napětí stěny LK (wall stress). 30 To vysvětluje absenci poklesu BNP i zjištěné snížení EFLK. V souvislosti s výkonem však nebylo zaznamenáno akutní zhoršení systolické funkce LK při nepoměru mezi preloadem a afterloadem (tzv.…”