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Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device
Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918912/ https://www.ncbi.nlm.nih.gov/pubmed/33673247 http://dx.doi.org/10.3390/jcm10040734 |
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author | Freixa, Xavier Estévez-Loureiro, Rodrigo Carrasco-Chinchilla, Fernando Millán, Xavier Amat-Santos, Ignacio Regueiro, Ander Nombela-Franco, Luis Pascual, Isaac Cid, Belen López-Mínguez, José Ramón Hernández-Antolín, Rosa Ana Cruz-González, Ignacio Andraka, Leire Goicolea, Javier Ruíz-Quevedo, Valeriano Díez, Jose Luís Berenguer, Alberto Baz, José Antonio Pan, Manuel Benito-González, Tomas Briales, Juan H. Alonso Li, Chi Hion Sanchis, Laura Serrador, Ana Jiménez-Quevedo, Pilar Avanzas, Pablo Salido, Luisa Fernández-Vázquez, Felipe Hernández-García, José Maria Arzamendi, Dabit |
author_facet | Freixa, Xavier Estévez-Loureiro, Rodrigo Carrasco-Chinchilla, Fernando Millán, Xavier Amat-Santos, Ignacio Regueiro, Ander Nombela-Franco, Luis Pascual, Isaac Cid, Belen López-Mínguez, José Ramón Hernández-Antolín, Rosa Ana Cruz-González, Ignacio Andraka, Leire Goicolea, Javier Ruíz-Quevedo, Valeriano Díez, Jose Luís Berenguer, Alberto Baz, José Antonio Pan, Manuel Benito-González, Tomas Briales, Juan H. Alonso Li, Chi Hion Sanchis, Laura Serrador, Ana Jiménez-Quevedo, Pilar Avanzas, Pablo Salido, Luisa Fernández-Vázquez, Felipe Hernández-García, José Maria Arzamendi, Dabit |
author_sort | Freixa, Xavier |
collection | PubMed |
description | Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system. Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017. The cohort was divided into three groups according to the use of the first-generation Mitraclip during the first (control-1) or second half (control-2) or the Mitraclip NT system. Results: A total of 545 consecutive patients were included in the study. Among all, 182 (33.3%), 183 (33.3%), and 180 (33.3%) patients underwent mitral repair in the control-1, control-2, and NT cohorts, respectively. Procedural success was achieved in 93.3% of patients without differences between groups. Major adverse events did not statistically differ among groups, but there was a higher rate of pericardial effusion in the control-1 group (4.3%, 0.6%, and 2.6%, respectively; p = 0.025). The composite endpoint of death, surgery, and admission for congestive heart failure (CHF) at 12 months was lower in the NT group (23.5% in control-1, 22.5% in control-2, and 8.3% in the NT group; p = 0.032). Conclusions: The present paper shows that contemporary clinical outcomes of patients undergoing PMVR with the Mitraclip system have improved over time. |
format | Online Article Text |
id | pubmed-7918912 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79189122021-03-02 Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device Freixa, Xavier Estévez-Loureiro, Rodrigo Carrasco-Chinchilla, Fernando Millán, Xavier Amat-Santos, Ignacio Regueiro, Ander Nombela-Franco, Luis Pascual, Isaac Cid, Belen López-Mínguez, José Ramón Hernández-Antolín, Rosa Ana Cruz-González, Ignacio Andraka, Leire Goicolea, Javier Ruíz-Quevedo, Valeriano Díez, Jose Luís Berenguer, Alberto Baz, José Antonio Pan, Manuel Benito-González, Tomas Briales, Juan H. Alonso Li, Chi Hion Sanchis, Laura Serrador, Ana Jiménez-Quevedo, Pilar Avanzas, Pablo Salido, Luisa Fernández-Vázquez, Felipe Hernández-García, José Maria Arzamendi, Dabit J Clin Med Article Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system. Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017. The cohort was divided into three groups according to the use of the first-generation Mitraclip during the first (control-1) or second half (control-2) or the Mitraclip NT system. Results: A total of 545 consecutive patients were included in the study. Among all, 182 (33.3%), 183 (33.3%), and 180 (33.3%) patients underwent mitral repair in the control-1, control-2, and NT cohorts, respectively. Procedural success was achieved in 93.3% of patients without differences between groups. Major adverse events did not statistically differ among groups, but there was a higher rate of pericardial effusion in the control-1 group (4.3%, 0.6%, and 2.6%, respectively; p = 0.025). The composite endpoint of death, surgery, and admission for congestive heart failure (CHF) at 12 months was lower in the NT group (23.5% in control-1, 22.5% in control-2, and 8.3% in the NT group; p = 0.032). Conclusions: The present paper shows that contemporary clinical outcomes of patients undergoing PMVR with the Mitraclip system have improved over time. MDPI 2021-02-12 /pmc/articles/PMC7918912/ /pubmed/33673247 http://dx.doi.org/10.3390/jcm10040734 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Freixa, Xavier Estévez-Loureiro, Rodrigo Carrasco-Chinchilla, Fernando Millán, Xavier Amat-Santos, Ignacio Regueiro, Ander Nombela-Franco, Luis Pascual, Isaac Cid, Belen López-Mínguez, José Ramón Hernández-Antolín, Rosa Ana Cruz-González, Ignacio Andraka, Leire Goicolea, Javier Ruíz-Quevedo, Valeriano Díez, Jose Luís Berenguer, Alberto Baz, José Antonio Pan, Manuel Benito-González, Tomas Briales, Juan H. Alonso Li, Chi Hion Sanchis, Laura Serrador, Ana Jiménez-Quevedo, Pilar Avanzas, Pablo Salido, Luisa Fernández-Vázquez, Felipe Hernández-García, José Maria Arzamendi, Dabit Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device |
title | Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device |
title_full | Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device |
title_fullStr | Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device |
title_full_unstemmed | Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device |
title_short | Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device |
title_sort | percutaneous mitral valve repair: outcome improvement with operator experience and a second-generation device |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918912/ https://www.ncbi.nlm.nih.gov/pubmed/33673247 http://dx.doi.org/10.3390/jcm10040734 |
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