PMID- 24013059 OWN - NLM STAT- MEDLINE DCOM- 20140224 LR - 20171028 IS - 1558-3597 (Electronic) IS - 0735-1097 (Linking) VI - 62 IP - 25 DP - 2013 Dec 24 TI - Echocardiographic and clinical outcomes of central versus noncentral percutaneous edge-to-edge repair of degenerative mitral regurgitation. PG - 2370-2377 LID - S0735-1097(13)04043-6 [pii] LID - 10.1016/j.jacc.2013.05.093 [doi] AB - OBJECTIVES: This study aimed to assess the clinical and echocardiographic results of MitraClip implantation in noncentral degenerative mitral regurgitation (dMR) compared with central dMR. BACKGROUND: It is unknown whether the use of MitraClip therapy in noncentral dMR is as safe and effective as in central dMR. METHODS: We analyzed a multicenter registry of 173 patients treated with the MitraClip and compared results of central and noncentral dMR. RESULTS: Seventy-nine patients (age 79.2 +/- 8.0 years, 58.2% men) had dMR. Forty-nine patients (62%) had central dMR, with the remainder classified as noncentral dMR (n = 30, 38%). Patients with noncentral dMR had a wider pre-procedural vena contracta (8.5 +/- 2.0 mm vs. 6.9 +/- 2.2 mm, p = 0.039) and higher systolic pulmonary pressure (57.9 +/- 18.0 vs. 47.3 +/- 13.0 mm Hg, p = 0.019). Procedural success was the same in both groups (95.5% central vs. 96.7% noncentral, p = 0.866). Post-procedural MR and New York Heart Association (NYHA) functional class at 1 month (MR II, 21.1% vs. 0%, p = 0.128) did not differ between groups. There were also no differences in serious post-procedural adverse events: partial clip detachment (central n = 1 [2.0%] vs. noncentral n = 1 [3.3%], p = 1.000), death (5.4% central vs. 13.0% noncentral, p = 0.298), or heart failure admission (10.8% central vs. 8.7% noncentral, p = 0.791). CONCLUSIONS: In experienced centers, MitraClip treatment can be performed safely and effectively in both central and noncentral dMR. CI - Copyright (c) 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Estevez-Loureiro, Rodrigo AU - Estevez-Loureiro R AD - National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. FAU - Franzen, Olaf AU - Franzen O AD - Division of Cardiology, Rigshospitalet, Copenhagen, Denmark. Electronic address: owfranzen@gmx.de. FAU - Winter, Reidar AU - Winter R AD - Unit for Interventional Cardiology, Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. FAU - Sondergaard, Lars AU - Sondergaard L AD - Division of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Jacobsen, Per AU - Jacobsen P AD - Unit for Interventional Cardiology, Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. FAU - Cheung, Gary AU - Cheung G AD - Division of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Moat, Neil AU - Moat N AD - National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. FAU - Ihlemann, Nikolaj AU - Ihlemann N AD - Division of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Ghione, Matteo AU - Ghione M AD - National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. FAU - Price, Susanna AU - Price S AD - National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. FAU - Duncan, Alison AU - Duncan A AD - National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. FAU - Streit Rosenberg, Tine AU - Streit Rosenberg T AD - Division of Cardiology, Rigshospitalet, Copenhagen, Denmark. FAU - Barker, Sarah AU - Barker S AD - National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. FAU - Di Mario, Carlo AU - Di Mario C AD - National Institute Health Research Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. FAU - Settergren, Magnus AU - Settergren M AD - Unit for Interventional Cardiology, Department of Cardiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study DEP - 20130904 PL - United States TA - J Am Coll Cardiol JT - Journal of the American College of Cardiology JID - 8301365 SB - IM CIN - J Am Coll Cardiol. 2013 Dec 24;62(25):2378-81. PMID: 24013060 MH - Aged MH - Aged, 80 and over MH - Catheterization, Central Venous/*methods MH - Echocardiography, Transesophageal/*methods MH - Female MH - Follow-Up Studies MH - Heart Valve Prosthesis Implantation/*methods MH - Humans MH - Kaplan-Meier Estimate MH - Male MH - Mitral Valve Insufficiency/*diagnostic imaging/mortality/*surgery MH - Retrospective Studies MH - Treatment Outcome OTO - NOTNLM OT - 2-dimensional OT - 2D OT - 3-dimensional OT - 3D OT - LV OT - MR OT - MV OT - NYHA OT - New York Heart Association OT - TEE OT - catheter-based-therapy OT - dMR OT - degenerative mitral regurgitation OT - heart valves OT - left ventricular OT - mitral regurgitation OT - mitral valve OT - transesophageal echocardiography EDAT- 2013/09/10 06:00 MHDA- 2014/02/25 06:00 CRDT- 2013/09/10 06:00 PHST- 2013/02/05 00:00 [received] PHST- 2013/04/21 00:00 [revised] PHST- 2013/05/14 00:00 [accepted] PHST- 2013/09/10 06:00 [entrez] PHST- 2013/09/10 06:00 [pubmed] PHST- 2014/02/25 06:00 [medline] AID - S0735-1097(13)04043-6 [pii] AID - 10.1016/j.jacc.2013.05.093 [doi] PST - ppublish SO - J Am Coll Cardiol. 2013 Dec 24;62(25):2370-2377. doi: 10.1016/j.jacc.2013.05.093. Epub 2013 Sep 4.