PMID- 38353680
OWN - NLM
STAT- Publisher
LR  - 20240214
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Linking)
DP  - 2024 Feb 14
TI  - Valve unit instead of intensive or intermediate care unit admission following 
      transcatheter edge-to-edge mitral valve repair is safe and reduces postprocedural 
      complications.
LID - 10.1007/s00392-024-02384-8 [doi]
AB  - BACKGROUND: Transcatheter edge-to-edge mitral valve repair (M-TEER) is often 
      performed in general anesthesia, and postprocedural monitoring is usually 
      warranted on an intensive or intermediate care unit (ICU/IMC). We evaluated the 
      implications of a dedicated valve unit (VU) instead of an ICU/IMC for monitoring 
      after M-TEER. METHODS AND RESULTS: In total, 624 patients were retrospectively 
      analyzed. A total of 312 patients were primarily transferred to either ICU or IMC 
      following M-TEER, and 312 patients were scheduled for the VU in the absence of 
      indications for ICU/IMC treatment. Hospital stay was significantly shorter in VU 
      patients (median 6.0 days (interquartile range (IQR) 5.0 - 8.0) vs. 7.0 days (IQR 
      6.0 - 10.0), p < 0.001) and their risk for infections (2.9 vs. 7.7%, p = 0.008) 
      and delirium (0.6 vs. 2.6%, p = 0.056) was substantially lower compared to 
      ICU/IMC patients. In-hospital mortality was similar in both groups (0.6% vs. 
      1.3%, p = 0.41). Fifty patients (16.0%) in the VU group had to cross over to 
      unplanned ICU/IMC admission. The most frequent indication was prolonged need for 
      catecholamines (52.0%). Patients with ICU/IMC crossover had more advanced stages 
      of heart failure (LV-EF < 30% in 36.0 vs. 16.0%, p = 0.001; severe concomitant 
      tricuspid regurgitation in 48.0 vs. 27.8%, p = 0.005) and an LV-EF < 30% was 
      independently associated with unplanned ICU/IMC admission. CONCLUSIONS: Following 
      M-TEER postprocedural monitoring on a VU instead of an ICU/IMC is safe, reduces 
      complications, and spares ICU capacities. Patients with advanced heart failure 
      have a higher risk for unplanned ICU/IMC treatment after M-TEER.
CI  - (c) 2024. The Author(s).
FAU - Groger, Matthias
AU  - Groger M
AD  - Department of Internal Medicine II, Ulm University Heart Center, University of 
      Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
FAU - Felbel, Dominik
AU  - Felbel D
AD  - Department of Internal Medicine II, Ulm University Heart Center, University of 
      Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
FAU - Paukovitsch, Michael
AU  - Paukovitsch M
AD  - Department of Internal Medicine II, Ulm University Heart Center, University of 
      Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
FAU - Schneider, Leonhard Moritz
AU  - Schneider LM
AD  - Department of Internal Medicine II, Ulm University Heart Center, University of 
      Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
FAU - Markovic, Sinisa
AU  - Markovic S
AD  - Department of Internal Medicine II, Ulm University Heart Center, University of 
      Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
FAU - Rottbauer, Wolfgang
AU  - Rottbauer W
AD  - Department of Internal Medicine II, Ulm University Heart Center, University of 
      Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
FAU - Kessler, Mirjam
AU  - Kessler M
AUID- ORCID: 0000-0001-6423-0508
AD  - Department of Internal Medicine II, Ulm University Heart Center, University of 
      Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. 
      mirjam.kessler@uniklinik-ulm.de.
LA  - eng
PT  - Journal Article
DEP - 20240214
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
SB  - IM
OTO - NOTNLM
OT  - Intensive care
OT  - Mitral valve repair
OT  - Postprocedural care
OT  - TEER
EDAT- 2024/02/14 12:50
MHDA- 2024/02/14 12:50
CRDT- 2024/02/14 11:03
PHST- 2023/10/15 00:00 [received]
PHST- 2024/01/19 00:00 [accepted]
PHST- 2024/02/14 12:50 [medline]
PHST- 2024/02/14 12:50 [pubmed]
PHST- 2024/02/14 11:03 [entrez]
AID - 10.1007/s00392-024-02384-8 [pii]
AID - 10.1007/s00392-024-02384-8 [doi]
PST - aheadofprint
SO  - Clin Res Cardiol. 2024 Feb 14. doi: 10.1007/s00392-024-02384-8.