scholarly journals TCT-804: Effectiveness of Percutaneous Reduction of Significant Mitral Regurgitation of Functional Etiology in High Surgical Risk Patients

2011 ◽  
Vol 58 (20) ◽  
pp. B214
Keyword(s):  
Mitral Regurgitation ◽  
Surgical Risk ◽  
Percutaneous Reduction ◽  
High Surgical Risk ◽  
Risk Patients

scholarly journals TCT-93 Percutaneous Reduction of Severe Mitral Regurgitation in Elderly High Surgical Risk Patients

2013 ◽  
Vol 62 (18) ◽  
pp. B30
Author(s):  
Michael Rinaldi ◽  
Saibal Kar ◽  
D. Scott Lim ◽  
James Hermiller ◽  
Richard Smalling ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Severe Mitral Regurgitation ◽  
Surgical Risk ◽  
Percutaneous Reduction ◽  
High Surgical Risk ◽  
Risk Patients

scholarly journals THE EVEREST II HIGH SURGICAL RISK COHORT: EFFECTIVENESS OF TRANSCATHETER REDUCTION OF SIGNIFICANT MITRAL REGURGITATION IN HIGH SURGICAL RISK PATIENTS

2013 ◽  
Vol 61 (10) ◽  
pp. E1958 ◽  
Author(s):  
Scott Lim ◽  
Saibal Kar ◽  
Peter Fail ◽  
Brian Whisenant ◽  
William Gray ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Risk Patients

Abstract 13513: MitraClip ® for Functional Mitral Regurgitation: Outcomes in Over 600 Patients

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Gorav Ailawadi ◽  
D. Scott Lim ◽  
Irving L Kron ◽  
Alfredo Trento ◽  
Saibal Kar ◽  
...  
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Mitral Regurgitation ◽  
Nyha Class ◽  
Class I ◽  
Symptom Improvement ◽  
Surgical Risk ◽  
High Risk Patients ◽  
High Surgical Risk ◽  
Risk Patients

Background: The treatment options for degenerative or primary mitral regurgitation (DMR) include mitral surgery and transcatheter edge-to-edge repair (MitraClip). However, the optimal therapy for patients with functional or secondary MR (FMR) remains unclear. The purpose of this study was to evaluate the 1 year outcomes of all patients with FMR undergoing MitraClip in the United States as part of the EVEREST (Endovascular Valve Edge-to-Edge Repair STudy) II study. Methods: Patients treated in the EVEREST II trial (randomized trial and continued access registries) with severe FMR were evaluated. Outcomes at 30 days and 1 year were analyzed and adjudicated by an independent core laboratory. Patients were further stratified by surgical risk (High risk= STS mortality score ≥12% or pre-specified risk factors). Results: A total of 619 patients (mean age=73.4 years) with FMR were treated with MitraClip. Comorbidities were common including coronary artery disease (81.1%), NYHA functional class III/IV (80.3%), and previous coronary artery bypass grafting (55.7%). Device implantation was achieved in 96.4% with a mean hospital stay of 3.3 days and an 87.2% discharge to home. At 30 days, mortality was 3.6% with a major adverse event rate of 9.2%. At 1 year, the survival was 78.3%, while the majority of survivors had MR≤2+ (84.5%) and significantly improved symptoms (83.2% NYHA Class I/II). The left ventricular end diastolic volume (LVEDV) improved from 162.5ml to 152.6ml (P<.001). When comparing high surgical risk patients (n=485; mean STS score=10.6±6.9%) to non-high risk patients (n=134), the 30 day mortality was similar (4.1% vs. 1.5%, P=.19), but the 1 year mortality was worse (22.7% vs. 13.4%, P=.02). Nevertheless, at 1 year, there were similar rates of MR reduction (MR≤2+: 83.9% vs. 87.3%) and improvement in LVEDV (-9.0ml vs -12.6ml). The non-high risk cases had greater symptom improvement (NYHA Class I/II: 91.2% vs. 80.2%, P=.001). Conclusions: MitraClip in patients with severe FMR is associated with excellent safety, positive ventricular remodeling, symptom improvement, and stable MR reduction at 1 year independent of surgical risk. Compared to high surgical risk patients, non-high risk patients may derive the greatest survival and symptom benefit.

Five-year outcomes of transcatheter reduction of significant mitral regurgitation in high-surgical-risk patients

Heart ◽  
2018 ◽  
Vol 105 (21) ◽  
pp. 1622-1628 ◽  
Author(s):  
Saibal Kar ◽  
Ted Feldman ◽  
Atif Qasim ◽  
Alfredo Trento ◽  
Samir Kapadia ◽  
...  
Keyword(s):  
High Risk ◽  
Mitral Regurgitation ◽  
Nyha Class ◽  
Left Ventricular ◽  
Functional Class ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Risk Patients

ObjectivesThis study evaluates the 5-year clinical outcomes of transcatheter mitral valve (MV) repair with the MitraClip device in patients at high risk for MV surgery treated in the Endovascular Valve Edge-to-Edge Repair (EVEREST) II High Risk Study (HRS).MethodsPatients with mitral regurgitation (MR) 3+ or 4+ and predicted surgical mortality risk ≥12% or surgeon assessment based on prespecified high-risk factors were enrolled. Patients prospectively consented to 5 years of follow-up.ResultsAt 5 years, clinical follow-up was achieved in 90% of 78 enrolled patients. The rate of postprocedural adverse events declined from 30 days to 1 year follow-up and was stable thereafter through 5 years. Two patients (2.6%) developed mitral stenosis (MS). Two patients underwent MV surgery, including one due to MS. A total of 42 deaths were reported through 5 years. Effectiveness measures at 5 years showed reductions in MR severity to ≤2+ in 75% of patients (p=0.0107), left ventricular (LV) end-diastolic volume (−38.2 mL; 95% CI −55.0 to –21.4; p<0.0001) and LV end-systolic volume (−14.6 mL; 95% CI −27.7 to −1.5; p=0.0303) compared with baseline. The New York Heart Association (NYHA) functional class improved from baseline to 5 years (p<0.005), and septal-lateral annular dimensions remained stable with no indication of mitral annular dilation through 5 years.ConclusionsThe EVEREST II HRS demonstrated long-term safety and efficacy of MitraClip in high-surgical-risk patients through 5 years. The observed mortality was most likely a consequence of the advanced age and comorbidity profile of the enrolled patients, while improvements in NYHA class in surviving patients were durable through long-term follow-up.Trial registration numberNCT01940120.

Bivalvular transcatheter treatment of high-surgical-risk patients with coexisting severe aortic stenosis and significant mitral regurgitation

2013 ◽  
Vol 167 (3) ◽  
pp. 716-720 ◽  
Author(s):  
Volker Rudolph ◽  
Johannes Schirmer ◽  
Olaf Franzen ◽  
Michael Schlüter ◽  
Moritz Seiffert ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Risk Patients

scholarly journals EFFECTIVENESS OF TRANSCATHETER REDUCTION OF SIGNIFICANT MITRAL REGURGITATION IN HIGH SURGICAL RISK PATIENTS WITH MITRACLIP: FINAL 5 YEAR RESULTS OF THE EVEREST II HIGH RISK REGISTRY

2014 ◽  
Vol 63 (12) ◽  
pp. A1683 ◽  
Author(s):  
Saibal Kar ◽  
Patrick Whitlow ◽  
Wesley Pedersen ◽  
Scott Lim ◽  
Richard Smalling ◽  
...  
Keyword(s):  
High Risk ◽  
Mitral Regurgitation ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Risk Patients

scholarly journals MitraClip Treatment of Moderate-to-Severe and Severe Mitral Regurgitation in High Surgical Risk Patients　― Real-World 1-Year Outcomes From Japan ―

2021 ◽  
Author(s):  
Takashi Matsumoto ◽  
Shunsuke Kubo ◽  
Masaki Izumo ◽  
Shingo Mizuno ◽  
Shinichi Shirai ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Real World ◽  
Severe Mitral Regurgitation ◽  
Surgical Risk ◽  
High Surgical Risk ◽  
Risk Patients
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