PMID- 33303117
OWN - NLM
STAT- MEDLINE
DCOM- 20210809
LR  - 20210809
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Linking)
VI  - 13
IP  - 23
DP  - 2020 Dec 14
TI  - Transcatheter Treatment of Residual Significant Mitral Regurgitation Following 
      TAVR: A Multicenter Registry.
PG  - 2782-2791
LID - S1936-8798(20)31549-1 [pii]
LID - 10.1016/j.jcin.2020.07.014 [doi]
AB  - OBJECTIVES: The aim of this study was to describe baseline characteristics, and 
      periprocedural and mid-term outcomes of patients undergoing transcatheter mitral 
      valve interventions post-transcatheter aortic valve replacement (TAVR) and 
      examine their clinical benefit. BACKGROUND: The optimal management of residual 
      mitral regurgitation (MR) post-TAVR is challenging. METHODS: This was an 
      international registry of 23 TAVR centers. RESULTS: In total, 106 of 24,178 
      patients (0.43%) underwent mitral interventions post-TAVR (100 staged, 6 
      concomitant), most commonly percutaneous edge-to-edge mitral valve repair (PMVR). 
      The median interval post-TAVR was 164 days. Mean age was 79.5 +/- 7.2 years, MR was 
      >moderate in 97.2%, technical success was 99.1%, and 30-day device success rate 
      was 88.7%. There were 18 periprocedural complications (16.9%) including 4 deaths. 
      During a median follow-up of 464 days, the cumulative risk for 3-year mortality 
      was 29.0%. MR grade and New York Heart Association (NYHA) functional class 
      improved dramatically; at 1 year, MR was moderate or less in 90.9% of patients 
      (mild or less in 69.1%), and 85.9% of patients were in NYHA functional class 
      I/II. Staged PMVR was associated with lower mortality versus medical treatment 
      (57.5% vs. 30.8%) in a propensity-matched cohort (n = 156), but this was not 
      statistically significant (hazard ratio: 1.75; p = 0.05). CONCLUSIONS: For 
      patients who continue to have significant MR, remain symptomatic post-TAVR, and 
      are anatomically suitable for transcatheter interventions, these interventions 
      are feasible, safe, and associated with significant improvement in MR grade and 
      NYHA functional class. These results apply mainly to PMVR. A staged PMVR strategy 
      was associated with markedly lower mortality, but this was not statistically 
      significant. (Transcatheter Treatment for Combined Aortic and Mitral Valve 
      Disease. The Aortic+Mitral TRAnsCatheter Valve Registry [AMTRAC]; NCT04031274).
CI  - Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Witberg, Guy
AU  - Witberg G
AD  - Department of Cardiology, Rabin Medical Centre, Petach-Tikva, Israel; Sackler 
      School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: 
      vitberguy@gmail.com.
FAU - Codner, Pablo
AU  - Codner P
AD  - Department of Cardiology, Rabin Medical Centre, Petach-Tikva, Israel; Sackler 
      School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
FAU - Landes, Uri
AU  - Landes U
AD  - Department of Cardiology, Rabin Medical Centre, Petach-Tikva, Israel; Sackler 
      School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; St. Paul's Hospital, 
      Vancouver, British Columbia, Canada.
FAU - Barbanti, Marco
AU  - Barbanti M
AD  - Division of Cardiology, University of Catania, Catania, Italy.
FAU - Valvo, Roberto
AU  - Valvo R
AD  - Division of Cardiology, University of Catania, Catania, Italy.
FAU - De Backer, Ole
AU  - De Backer O
AD  - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, 
      Denmark.
FAU - Ooms, Joris F
AU  - Ooms JF
AD  - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, 
      Rotterdam, the Netherlands.
FAU - Sievert, Kolja
AU  - Sievert K
AD  - Cardiovascular Center Frankfurt, Frankfurt, Germany.
FAU - El Sabbagh, Abdallah
AU  - El Sabbagh A
AD  - Department of Cardiovascular Medicine, Mayo Clinic Hospital, Rochester, 
      Minnesota, USA.
FAU - Jimenez-Quevedo, Pilar
AU  - Jimenez-Quevedo P
AD  - Cardiovascular Institute. Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
FAU - Brennan, Paul F
AU  - Brennan PF
AD  - Department of Cardiology, Royal Victoria Hospital, Belfast Health & Social Care 
      Trust, Belfast, United Kingdom.
FAU - Sedaghat, Alexander
AU  - Sedaghat A
AD  - Herzzentrum Bonn Universitatsklinikum Bonn, Bonn, Germany.
FAU - Masiero, Giulia
AU  - Masiero G
AD  - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua 
      Medical School, Padua, Italy.
FAU - Werner, Paul
AU  - Werner P
AD  - Division of Cardiac Surgery Medical University of Vienna, Vienna, Austria.
FAU - Overtchouk, Pavel
AU  - Overtchouk P
AD  - Department of Medicine, Division of Cardiology, McGill University Health Centre, 
      Royal Victoria Hospital, Montreal, Quebec, Canada.
FAU - Watanabe, Yusuke
AU  - Watanabe Y
AD  - Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.
FAU - Montorfano, Matteo
AU  - Montorfano M
AD  - Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan 
      Italy.
FAU - Bijjam, Venu Reddy
AU  - Bijjam VR
AD  - Department of Cardiology, University Hospital, and National University of Ireland 
      Galway, Galway, Ireland.
FAU - Hein, Manuel
AU  - Hein M
AD  - Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Fiorina, Claudia
AU  - Fiorina C
AD  - Cardiovascular Department, Spedali Civili, Brescia, Italy.
FAU - Arzamendi, Dabit
AU  - Arzamendi D
AD  - Hospital de Sant Creu i Sant Pau Barcelona, Barcelona, Spain.
FAU - Rodriguez-Gabella, Tania
AU  - Rodriguez-Gabella T
AD  - CIBERCV, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
FAU - Fernandez-Vazquez, Felipe
AU  - Fernandez-Vazquez F
AD  - Department of Cardiology, University Hospital of Leon, Leon, Spain.
FAU - Baz, Jose A
AU  - Baz JA
AD  - Servicio de Cardiologia, Hospital Alvaro Cunqueiro, Vigo, Pontevedra, Spain.
FAU - Laperche, Clemence
AU  - Laperche C
AD  - Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France.
FAU - Grasso, Carmelo
AU  - Grasso C
AD  - Division of Cardiology, University of Catania, Catania, Italy.
FAU - Branca, Luca
AU  - Branca L
AD  - Cardiovascular Department, Spedali Civili, Brescia, Italy.
FAU - Estevez-Loureiro, Rodrigo
AU  - Estevez-Loureiro R
AD  - Servicio de Cardiologia, Hospital Alvaro Cunqueiro, Vigo, Pontevedra, Spain.
FAU - Benito-Gonzalez, Tomas
AU  - Benito-Gonzalez T
AD  - Department of Cardiology, University Hospital of Leon, Leon, Spain.
FAU - Amat Santos, Ignacio J
AU  - Amat Santos IJ
AD  - CIBERCV, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
FAU - Ruile, Philipp
AU  - Ruile P
AD  - Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad 
      Krozingen, Bad Krozingen, Germany.
FAU - Mylotte, Darren
AU  - Mylotte D
AD  - Department of Cardiology, University Hospital, and National University of Ireland 
      Galway, Galway, Ireland.
FAU - Buzzatti, Nicola
AU  - Buzzatti N
AD  - Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan 
      Italy.
FAU - Piazza, Nicolo
AU  - Piazza N
AD  - Department of Medicine, Division of Cardiology, McGill University Health Centre, 
      Royal Victoria Hospital, Montreal, Quebec, Canada.
FAU - Andreas, Martin
AU  - Andreas M
AD  - Division of Cardiac Surgery Medical University of Vienna, Vienna, Austria.
FAU - Tarantini, Giuseppe
AU  - Tarantini G
AD  - Department of Cardiac, Thoracic and Vascular Sciences, University of Padua 
      Medical School, Padua, Italy.
FAU - Sinning, Jan-Malte
AU  - Sinning JM
AD  - Herzzentrum Bonn Universitatsklinikum Bonn, Bonn, Germany.
FAU - Spence, Mark S
AU  - Spence MS
AD  - Department of Cardiology, Royal Victoria Hospital, Belfast Health & Social Care 
      Trust, Belfast, United Kingdom.
FAU - Nombela-Franco, Luis
AU  - Nombela-Franco L
AD  - Cardiovascular Institute. Hospital Clinico San Carlos, IdISSC, Madrid, Spain.
FAU - Guerrero, Mayra
AU  - Guerrero M
AD  - Department of Cardiovascular Medicine, Mayo Clinic Hospital, Rochester, 
      Minnesota, USA.
FAU - Sievert, Horst
AU  - Sievert H
AD  - Cardiovascular Center Frankfurt, Frankfurt, Germany; Anglia Ruskin University, 
      Chelmsford, United Kingdom; University of California San Francisco, San 
      Francisco, California, USA; Yunnan Hospital Fuwai, Kunming, China.
FAU - Sondergaard, Lars
AU  - Sondergaard L
AD  - The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, 
      Denmark.
FAU - Van Mieghem, Nicolas M
AU  - Van Mieghem NM
AD  - Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, 
      Rotterdam, the Netherlands.
FAU - Tchetche, Didier
AU  - Tchetche D
AD  - Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France.
FAU - Webb, John G
AU  - Webb JG
AD  - Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver, British 
      Columbia, Canada.
FAU - Kornowski, Ran
AU  - Kornowski R
AD  - Department of Cardiology, Rabin Medical Centre, Petach-Tikva, Israel; Sackler 
      School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
LA  - eng
SI  - ClinicalTrials.gov/NCT04031274
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
SB  - IM
CIN - JACC Cardiovasc Interv. 2020 Dec 14;13(23):2792-2794. PMID: 33303118
EIN - JACC Cardiovasc Interv. 2021 Mar 8;14(5):594. PMID: 33663796
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/surgery
MH  - Aortic Valve Stenosis/surgery
MH  - Humans
MH  - *Mitral Valve Insufficiency/surgery
MH  - Registries
MH  - Severity of Illness Index
MH  - *Transcatheter Aortic Valve Replacement
MH  - Treatment Outcome
OTO - NOTNLM
OT  - TAVR
OT  - TMVR/r
OT  - aortic stenosis
OT  - mitral regurgitation
COIS- Author Disclosures Dr. Barbanti has received consultant fees from Edwards 
      Lifesciences. Dr. De Backer has received research grants and consultant fees from 
      Abbott and Boston Scientific. Dr. Sievert has received institutional honoraria, 
      travel expenses, and consulting fees from 4tech Cardio, Abbott, Ablative 
      Solutions, Ancora Heart, Append Medical, Bavaria Medizin Technologie GmbH, 
      Bioventrix, Boston Scientific, Carag, CardiacDimensions, Cardimed, Celonova, 
      Comed B.V., Contego, CVRx, Dinova, Edwards Lifesciences, Endologix, Hemoteq, 
      Hangzhou Nuomao Medtech, Holistick Medical, Lifetech, Maquet Getinge Group, 
      Medtronic, Mokita, Occlutech, Recor, RenalGuard, Terumo, Vascular Dynamics, 
      Vectorious Medtech, Venus, Venock, and Vivasure Medical. Dr. Grasso has been a 
      proctor for Abbott Vascular. Dr. Andreas has been a proctor for Abbott and 
      Edwards Lifesciences; and has received advisory board fees from Medtronic. Dr. 
      Guerrero has received research grant support from Edwards Lifesciences. Dr. Van 
      Mieghem has received research grant support from Abbott, Boston Scientific, 
      Edwards Lifesciences, Medtronic, PulseCath BV, and Daiichi-Sankyo; and advisory 
      fees from Abbott, Boston Scientific, Ancora, Medtronic, PulseCath BV, and 
      Daiichi-Sankyo. All other authors have reported that they have no relationships 
      relevant to the contents of this paper to disclose.
EDAT- 2020/12/12 06:00
MHDA- 2021/08/10 06:00
CRDT- 2020/12/11 05:38
PHST- 2020/04/23 00:00 [received]
PHST- 2020/06/01 00:00 [revised]
PHST- 2020/07/07 00:00 [accepted]
PHST- 2020/12/11 05:38 [entrez]
PHST- 2020/12/12 06:00 [pubmed]
PHST- 2021/08/10 06:00 [medline]
AID - S1936-8798(20)31549-1 [pii]
AID - 10.1016/j.jcin.2020.07.014 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2020 Dec 14;13(23):2782-2791. doi: 
      10.1016/j.jcin.2020.07.014.