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MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study

BACKGROUND: Recurrence of mitral regurgitation (MR) after surgical mitral valve repair (SMVR) varies and may require reoperation. Redo mitral valve surgery can be technically challenging and is associated with increased risk of mortality and morbidity. We aimed to assess the feasibility and safety o...

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Autores principales: Rahhab, Zouhair, Lim, David Scott, Little, Stephen H., Taramasso, Maurizio, Kuwata, Shingo, Saccocci, Matteo, Tamburino, Corrado, Grasso, Carmelo, Frerker, Christian, Wißt, Theresa, Garberich, Ross, Hausleiter, Jörg, Braun, Daniel, Avenatti, Eleonora, Delgado, Victoria, Ussia, Gian Paolo, Castriota, Fausto, Nerla, Roberto, Ince, Hüseyin, Öner, Alper, Estevez‐Loureiro, Rodrigo, Latib, Azeem, Regazzoli, Damiano, Piazza, Nicolo, Alosaimi, Hind, de Jaegere, Peter P. T., Bax, Jeroen, Dvir, Danny, Maisano, Francesco, Sorajja, Paul, Reardon, Michael J., Van Mieghem, Nicolas M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174343/
https://www.ncbi.nlm.nih.gov/pubmed/33794658
http://dx.doi.org/10.1161/JAHA.120.019236
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author Rahhab, Zouhair
Lim, David Scott
Little, Stephen H.
Taramasso, Maurizio
Kuwata, Shingo
Saccocci, Matteo
Tamburino, Corrado
Grasso, Carmelo
Frerker, Christian
Wißt, Theresa
Garberich, Ross
Hausleiter, Jörg
Braun, Daniel
Avenatti, Eleonora
Delgado, Victoria
Ussia, Gian Paolo
Castriota, Fausto
Nerla, Roberto
Ince, Hüseyin
Öner, Alper
Estevez‐Loureiro, Rodrigo
Latib, Azeem
Regazzoli, Damiano
Piazza, Nicolo
Alosaimi, Hind
de Jaegere, Peter P. T.
Bax, Jeroen
Dvir, Danny
Maisano, Francesco
Sorajja, Paul
Reardon, Michael J.
Van Mieghem, Nicolas M.
author_facet Rahhab, Zouhair
Lim, David Scott
Little, Stephen H.
Taramasso, Maurizio
Kuwata, Shingo
Saccocci, Matteo
Tamburino, Corrado
Grasso, Carmelo
Frerker, Christian
Wißt, Theresa
Garberich, Ross
Hausleiter, Jörg
Braun, Daniel
Avenatti, Eleonora
Delgado, Victoria
Ussia, Gian Paolo
Castriota, Fausto
Nerla, Roberto
Ince, Hüseyin
Öner, Alper
Estevez‐Loureiro, Rodrigo
Latib, Azeem
Regazzoli, Damiano
Piazza, Nicolo
Alosaimi, Hind
de Jaegere, Peter P. T.
Bax, Jeroen
Dvir, Danny
Maisano, Francesco
Sorajja, Paul
Reardon, Michael J.
Van Mieghem, Nicolas M.
author_sort Rahhab, Zouhair
collection PubMed
description BACKGROUND: Recurrence of mitral regurgitation (MR) after surgical mitral valve repair (SMVR) varies and may require reoperation. Redo mitral valve surgery can be technically challenging and is associated with increased risk of mortality and morbidity. We aimed to assess the feasibility and safety of MitraClip as a treatment strategy after failed SMVR and identify procedure modifications to overcome technical challenges. METHODS AND RESULTS: This international multicenter observational retrospective study collected information for all patients from 16 high‐volume hospitals who were treated with MitraClip after failed SMVR from October 29, 2009, until August 1, 2017. Data were anonymously collected. Technical and device success were recorded per modified Mitral Valve Academic Research Consortium criteria. Overall, 104 consecutive patients were included. Median Society of Thoracic Surgeons score was 4.5% and median age was 73 years. At baseline, the majority of patients (82%) were in New York Heart Association class ≥III and MR was moderate or higher in 86% of patients. The cause of MR pre‐SMVR was degenerative in 50%, functional in 35%, mixed in 8%, and missing/unknown in 8% of patients. The median time between SMVR and MitraClip was 5.3 (1.9–9.7) years. Technical and device success were 90% and 89%, respectively. Additional/modified imaging was applied in 21% of cases. An MR reduction of ≥1 grade was achieved in 94% of patients and residual MR was moderate or less in 90% of patients. In‐hospital all‐cause mortality was 2%, and 86% of patients were in New York Heart Association class ≤II. CONCLUSIONS: MitraClip is a safe and less invasive treatment option for patients with recurrent MR after failed SMVR. Additional/modified imaging may help overcome technical challenges during leaflet grasping.
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spelling pubmed-81743432021-06-11 MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study Rahhab, Zouhair Lim, David Scott Little, Stephen H. Taramasso, Maurizio Kuwata, Shingo Saccocci, Matteo Tamburino, Corrado Grasso, Carmelo Frerker, Christian Wißt, Theresa Garberich, Ross Hausleiter, Jörg Braun, Daniel Avenatti, Eleonora Delgado, Victoria Ussia, Gian Paolo Castriota, Fausto Nerla, Roberto Ince, Hüseyin Öner, Alper Estevez‐Loureiro, Rodrigo Latib, Azeem Regazzoli, Damiano Piazza, Nicolo Alosaimi, Hind de Jaegere, Peter P. T. Bax, Jeroen Dvir, Danny Maisano, Francesco Sorajja, Paul Reardon, Michael J. Van Mieghem, Nicolas M. J Am Heart Assoc Original Research BACKGROUND: Recurrence of mitral regurgitation (MR) after surgical mitral valve repair (SMVR) varies and may require reoperation. Redo mitral valve surgery can be technically challenging and is associated with increased risk of mortality and morbidity. We aimed to assess the feasibility and safety of MitraClip as a treatment strategy after failed SMVR and identify procedure modifications to overcome technical challenges. METHODS AND RESULTS: This international multicenter observational retrospective study collected information for all patients from 16 high‐volume hospitals who were treated with MitraClip after failed SMVR from October 29, 2009, until August 1, 2017. Data were anonymously collected. Technical and device success were recorded per modified Mitral Valve Academic Research Consortium criteria. Overall, 104 consecutive patients were included. Median Society of Thoracic Surgeons score was 4.5% and median age was 73 years. At baseline, the majority of patients (82%) were in New York Heart Association class ≥III and MR was moderate or higher in 86% of patients. The cause of MR pre‐SMVR was degenerative in 50%, functional in 35%, mixed in 8%, and missing/unknown in 8% of patients. The median time between SMVR and MitraClip was 5.3 (1.9–9.7) years. Technical and device success were 90% and 89%, respectively. Additional/modified imaging was applied in 21% of cases. An MR reduction of ≥1 grade was achieved in 94% of patients and residual MR was moderate or less in 90% of patients. In‐hospital all‐cause mortality was 2%, and 86% of patients were in New York Heart Association class ≤II. CONCLUSIONS: MitraClip is a safe and less invasive treatment option for patients with recurrent MR after failed SMVR. Additional/modified imaging may help overcome technical challenges during leaflet grasping. John Wiley and Sons Inc. 2021-04-02 /pmc/articles/PMC8174343/ /pubmed/33794658 http://dx.doi.org/10.1161/JAHA.120.019236 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Rahhab, Zouhair
Lim, David Scott
Little, Stephen H.
Taramasso, Maurizio
Kuwata, Shingo
Saccocci, Matteo
Tamburino, Corrado
Grasso, Carmelo
Frerker, Christian
Wißt, Theresa
Garberich, Ross
Hausleiter, Jörg
Braun, Daniel
Avenatti, Eleonora
Delgado, Victoria
Ussia, Gian Paolo
Castriota, Fausto
Nerla, Roberto
Ince, Hüseyin
Öner, Alper
Estevez‐Loureiro, Rodrigo
Latib, Azeem
Regazzoli, Damiano
Piazza, Nicolo
Alosaimi, Hind
de Jaegere, Peter P. T.
Bax, Jeroen
Dvir, Danny
Maisano, Francesco
Sorajja, Paul
Reardon, Michael J.
Van Mieghem, Nicolas M.
MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study
title MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study
title_full MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study
title_fullStr MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study
title_full_unstemmed MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study
title_short MitraClip After Failed Surgical Mitral Valve Repair—An International Multicenter Study
title_sort mitraclip after failed surgical mitral valve repair—an international multicenter study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174343/
https://www.ncbi.nlm.nih.gov/pubmed/33794658
http://dx.doi.org/10.1161/JAHA.120.019236
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