PMID- 27056128
OWN - NLM
STAT- MEDLINE
DCOM- 20170109
LR  - 20170110
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Linking)
VI  - 11
IP  - 14
DP  - 2016 Apr 8
TI  - Impact of percutaneous mitral valve repair using the MitraClip system on 
      tricuspid regurgitation.
PG  - e1680-6
LID - EIJV11I14A320 [pii]
LID - 10.4244/EIJV11I14A320 [doi]
AB  - AIMS: Tricuspid regurgitation (TR) severity and right ventricular (RV) 
      dysfunction have been identified as significant predictors of outcome after 
      mitral valve surgery. The aim of the present study was to investigate the impact 
      of percutaneous mitral valve repair (PMVR) with the MitraClip system on 
      functional TR severity and RV function. METHODS AND RESULTS: Among 119 
      consecutive patients with severe mitral regurgitation who underwent PMVR, 67 had 
      complete baseline and follow-up transthoracic echocardiography after 3-12 months 
      (6.8+/-2.9 months). TR severity was graded as mild, moderate, and severe. RV 
      systolic function was assessed by fractional area change (FAC) and tricuspid 
      annular plane systolic excursion (TAPSE). Clinical endpoints at follow-up 
      included mortality, reoperation of the mitral valve, hospitalisation for 
      congestive heart failure and New York Heart Association (NYHA) functional class. 
      After PMVR, a significant decrease in TR severity (by at least one grade) was 
      observed in 22 (33%) patients, while an increase occurred in only seven (10%) 
      patients (p=0.02). Overall, systolic RV function (FAC and TAPSE), RV dimensions, 
      and tricuspid annular diameter did not change significantly. Baseline SPAP was 
      significantly higher (57+/-15 vs. 43+/-14 mmHg, p=0.002) and SPAP reduction 
      significantly larger (-14+/-13 versus 1+/-15 mmHg, p=0.012) in patients who improved 
      their TR. Multivariate logistic regression analysis identified the change in SPAP 
      as the only significant predictor of changes in TR (odds ratio [OR] [for every 
      change in SPAP by 10 mmHg] 1.90, 95% CI: 1.02+/-3.54; p=0.044). Patients with 
      mild/moderate TR at follow-up after PMVR had lower event rates compared to those 
      with severe TR (35% vs. 78%, respectively, p=0.025). CONCLUSIONS: PMVR using the 
      MitraClip device improves functional TR severity in approximately one third of 
      patients, particularly in those who experience a significant SPAP reduction after 
      the procedure.
FAU - Frangieh, Antonio H
AU  - Frangieh AH
AD  - Andreas Gruntzig Cardiac Catheterization Laboratories, University Heart Center, 
      Zurich, Switzerland.
FAU - Gruner, Christiane
AU  - Gruner C
FAU - Mikulicic, Fran
AU  - Mikulicic F
FAU - Attinger-Toller, Adrian
AU  - Attinger-Toller A
FAU - Tanner, Felix C
AU  - Tanner FC
FAU - Taramasso, Maurizio
AU  - Taramasso M
FAU - Corti, Roberto
AU  - Corti R
FAU - Grunenfelder, Jurg
AU  - Grunenfelder J
FAU - Lusche, Thomas F
AU  - Lusche TF
FAU - Ruschitzka, Frank
AU  - Ruschitzka F
FAU - Bettex, Dominique
AU  - Bettex D
FAU - Maisano, Francesco
AU  - Maisano F
FAU - Gaemperli, Oliver
AU  - Gaemperli O
LA  - eng
PT  - Journal Article
DEP - 20160408
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cardiac Surgical Procedures/methods
MH  - Echocardiography/methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*surgery
MH  - Postoperative Complications
MH  - Treatment Outcome
MH  - Tricuspid Valve/*surgery
MH  - Tricuspid Valve Insufficiency/diagnosis/*surgery
MH  - Ventricular Dysfunction, Right/surgery
EDAT- 2016/04/09 06:00
MHDA- 2017/01/10 06:00
CRDT- 2016/04/09 06:00
PHST- 2016/04/09 06:00 [entrez]
PHST- 2016/04/09 06:00 [pubmed]
PHST- 2017/01/10 06:00 [medline]
AID - EIJV11I14A320 [pii]
AID - 10.4244/EIJV11I14A320 [doi]
PST - epublish
SO  - EuroIntervention. 2016 Apr 8;11(14):e1680-6. doi: 10.4244/EIJV11I14A320.