scholarly journals TCT-58 Immediate and long-term outcomes of ischemic versus non-ischemic functional mitral regurgitation in patients treated with MitraClip: insights from the 2011-12 Pilot European Sentinel Registry of Percutaneous Edge-to-Edge Mitral Valve Repair

2015 ◽  
Vol 66 (15) ◽  
pp. B26
Author(s):  
Michele Pighi ◽  
Rodrigo Estevez-Loureiro ◽  
Francesco Maisano ◽  
Gian Paolo Ussia ◽  
Gianni Dall'Ara ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
Long Term Outcomes

scholarly journals Long-term outcomes of rheumatic mitral valve repair: Is it worthwhile to do it?

2020 ◽  
pp. 021849232097076
Author(s):  
Somchai Waikittipong
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Young Patients ◽  
Class Iii ◽  
Valve Repair ◽  
Long Term Outcomes ◽  
Actuarial Survival

Aim This retrospective study was undertaken to evaluate the long-term outcomes of mitral valve repair in rheumatic patients. Methods From 2003 to 2019, 151 patients (mean age 26.5 ± 14.9 years; 68.9% female) underwent mitral valve repair. Fifty-three (35.1%) had atrial fibrillation, and 79 (52.3%) were in New York Heart Association class III/IV. Pure mitral regurgitation was present in 109 (72.2%) patients, pure stenosis in 9 (6%), and mixed regurgitation and stenosis in 33. Results Three (2%) patients died postoperatively and 4 (2.6%) were lost during follow-up. Mean follow-up was 90.5 ± 55.6 months. There were 22 (14.8%) late deaths. Actuarial survival at 5, 10, and 15 years was 90.7% ± 2.5%, 83.5% ± 3.6%, and 76.5 ± 6.1%, respectively. Twelve (8.5%) patients underwent reoperation. Freedom from reoperation at 5, 10, and 15 years was 96.1% ± 1.7%, 89.8% ± 3.2%, and 82.3% ± 6.1%, respectively. Forty-two (29.2%) patients developed recurrent mitral regurgitation. Freedom from recurrence of mitral regurgitation at 5, 10, and 15 years was 70.9% ± 4.3%, 56% ± 5.9%, and 53.3% ± 6.4%, respectively. Eighty-one (56.6%) patients were and free from all events during follow-up. Freedom from all events at 5, 10, and 15 years was 64.8% ± 4.1%, 48.6% ± 5.3%, and 43.7% ± 5.8%, respectively. Conclusions Although rheumatic mitral valve repair is associated with late recurrence of mitral regurgitation, it has benefits in selected patients, especially children and young patients who want to avoid the lifelong risks of anticoagulation. Long-term follow-up is essential in these patients.

Impact of recurrent mitral regurgitation after mitral valve repair for functional mitral regurgitation: long-term analysis of competing outcomes

2019 ◽  
Vol 40 (27) ◽  
pp. 2206-2214 ◽  
Author(s):  
Annelieke H J Petrus ◽  
Olaf M Dekkers ◽  
Laurens F Tops ◽  
Eva Timmer ◽  
Robert J M Klautz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
History Of ◽  
The Impact

Abstract Aims Recurrent mitral regurgitation (MR) has been reported after mitral valve repair for functional MR. However, the impact of recurrent MR on long-term survival remains poorly defined. In the present study, mortality-adjusted recurrent MR rates, the clinical impact of recurrent MR and its determinants were studied in patients after mitral valve repair with revascularization for functional MR in the setting of ischaemic heart disease. Methods and results Long-term clinical and echocardiographic outcome was evaluated in 261 consecutive patients after restrictive mitral annuloplasty and revascularization for moderate to severe functional MR, between 2000 and 2014. The cumulative incidence of recurrent MR ≥ Grade 2, assessed by competing risk analysis, was 9.6 ± 1.8% at 1-year, 20.3 ± 2.5% at 5-year, and 27.6 ± 2.9% at 10-year follow-up. Cumulative survival was 85.8% [95% confidence interval (CI) 81.0–90.0] at 1-year, 67.3% (95% CI 61.1–72.6%) at 5-year, and 46.1% (95% CI 39.4–52.6%) at 10-year follow-up. Age, preoperative New York Heart Association Class III or IV, a history of renal failure, and recurrence of MR expressed as a time-dependent variable [HR 3.28 (1.87–5.75), P < 0.001], were independently associated with an increased mortality risk. Female gender, a history of ST-elevation myocardial infarction, a preoperative QRS duration ≥120 ms, a higher preoperative MR grade, and a higher indexed left ventricular end-systolic volume were independently associated with an increased likelihood of recurrent MR. Conclusion Mitral valve repair for functional ischaemic MR resulted in a low incidence of recurrent MR with favourable clinical outcome up to 10 years after surgery. Presence of recurrent MR at any moment after surgery proved to be independently associated with an increased risk for mortality.

Repair Options for Mitral Regurgitation

2011 ◽  
Vol 7 (2) ◽  
pp. 131
Author(s):  
Ottavio Alfieri ◽  
Michele De Bonis ◽  
◽  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Surgical Techniques ◽  
Long Term Results ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
Term Survival ◽  
Mitral Repair

Mitral valve repair is the treatment of choice for severe degenerative mitral regurgitation providing better freedom from cardiac events, quality of life and long-term survival compared with mitral valve replacement. Increasing numbers of asymptomatic patients are therefore referred for mitral repair. With refinements of the surgical techniques, long-term results have further improved in the last decade. Certainly experience is crucial in determining the likelihood of success and patients with a mitral valve deemed reparable should be referred to centers with high volume and extensive experience in this field. In this article the current role of mitral valve repair in degenerative mitral regurgitation (MR) will be outlined. Moreover some important concepts regarding indication and techniques of mitral repair in the more challenging setting of secondary (functional) mitral regurgitation will be presented and discussed.

scholarly journals Interrelationship Between Kidney Function and Percutaneous Mitral Valve Interventions: A Comprehensive Review

2019 ◽  
Vol 15 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Kevin Bryan Lo ◽  
Sandeep Dayanand ◽  
Pradhum Ram ◽  
Pradeep Dayanand ◽  
Leandro N. Slipczuk ◽  
...  
Keyword(s):  
Renal Function ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Renal Dysfunction ◽  
Mitral Valve Repair ◽  
Current Evidence ◽  
Valve Repair ◽  
Long Term Outcomes ◽  
Percutaneous Mitral Valve Repair

Percutaneous mitral valve repair is emerging as a reasonable alternative especially in those with an unfavorable surgical risk profile in the repair of mitral regurgitation. At this time, our understanding of the effects of underlying renal dysfunction on outcomes with percutaneous mitral valve repair and the effects of this procedure itself on renal function is evolving, as more data emerges in this field. The current evidence suggests that the correction of mitral regurgitation via percutaneous mitral valve repair is associated with some degree of improvement in cardiac function, hemodynamics and renal function. The improvement in renal function was more significant for those with greater renal dysfunction at baseline. The presence of Chronic Kidney Disease (CKD) in turn has been associated with poor long-term outcomes including increased mortality and hospitalization among patients who undergo percutaneous mitral valve repair. This was true regardless of the degree of improvement in GFR post repair advanced CKD. The adverse impact of CKD on long-term outcomes was consistent across all studies and was more prominent in those with GFR<30 mL/min/1.73 m². It is clear that from these contrasting evidences of improved renal function post mitral valve repair but poor long-term outcomes including increased mortality in patients with CKD, that proper patient selection for percutaneous mitral valve repair is key. There is a need to have better-standardized criteria for patients who should qualify to have percutaneous mitral valve replacement with Mitraclip. In this new era of percutaneous mitral valve repair, much work needs to be done to optimize long-term patient outcomes.

Long-Term Outcomes after Mitral Valve Repair for Degenerative Mitral Regurgitation with Persistent Atrial Fibrillation

2014 ◽  
Vol 63 (03) ◽  
pp. 243-249 ◽  
Author(s):  
Yukikatsu Okada ◽  
Hideo Kanemitsu ◽  
Naoto Fukunaga ◽  
Yasunobu Konishi ◽  
Ken Nakamura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Persistent Atrial Fibrillation ◽  
Valve Repair ◽  
Long Term Outcomes

scholarly journals Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Benito Gonzalez ◽  
X Freixa ◽  
C Godino ◽  
M Taramasso ◽  
R Estevez-Loureiro ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Functional Mitral Regurgitation ◽  
Valve Repair ◽  
One Year ◽  
The Impact

Abstract Background Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. Methods We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction, functional mitral regurgitation grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Results 93 patients (68.2±10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-months follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0–17.8 vs 2.7–13.5, p=0.002), sustained VT or ventricular fibrillation (0.9–2.5 vs 0.5–2.9, p=0.012) and ICD antitachycardia therapies (2.5–12.0 vs 0.9–5.0, p=0.033) were observed. Conclusion PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort. Proportion of patients who presented ven Funding Acknowledgement Type of funding source: None

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