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Titel:

Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair: Mid-Term Outcomes From the CUTTING-EDGE International Registry.

Dokumenttyp:
Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Autor(en):
Kaneko, Tsuyoshi; Hirji, Sameer; Zaid, Syed; Lange, Rudiger; Kempfert, Jörg; Conradi, Lenard; Hagl, Christian; Borger, Michael A; Taramasso, Maurizio; Nguyen, Tom C; Ailawadi, Gorav; Shah, Ashish S; Smith, Robert L; Anselmi, Amedeo; Romano, Matthew A; Ben Ali, Walid; Ramlawi, Basel; Grubb, Kendra J; Robinson, Newell B; Pirelli, Luigi; Chu, Michael W A; Andreas, Martin; Obadia, Jean-Francois; Gennari, Marco; Garatti, Andrea; Tchetche, Didier; Nazif, Tamim M; Bapat, Vinayak N; Modine, Thomas; Dent...     »
Abstract:
OBJECTIVES: The aim of this study was to determine clinical and echocardiographic characteristics, mechanisms of failure, and outcomes of mitral valve (MV) surgery after transcatheter edge-to-edge repair (TEER). BACKGROUND: Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking. METHODS: Data from the multicenter, international CUTTING-EDGE registry were retrospectively analyzed. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 9.0 months (interquartile range [IQR]: 1.2-25.7 months) after MV surgery, and follow-up was 96.1% complete at 30 days and 81.1% complete at 1 year. RESULTS: From July 2009 to July 2020, 332 patients across 34 centers underwent MV surgery after TEER. The mean age was 73.8 ± 10.1 years, median Society of Thoracic Surgeons risk for MV repair at initial TEER was 4.0 (IQR: 2.3-7.3), and primary/mixed and secondary mitral regurgitation were present in 59.0% and 38.5%, respectively. The median interval from TEER to surgery was 3.5 months (IQR: 0.5-11.9 months), with overall median Society of Thoracic Surgeons risk of 4.8% for MV replacement (IQR: 2.8%-8.4%). The primary indication for surgery was recurrent mitral regurgitation (33.5%), and MV replacement and concomitant tricuspid surgery were performed in 92.5% and 42.2% of patients, respectively. The 30-day and 1-year mortality rates were 16.6% and 31.3%, respectively. On Kaplan-Meier analysis, the actuarial estimates of mortality were 24.1% at 1 year and 31.7% at 3 years after MV surgery. CONCLUSIONS: In this first report of the CUTTING-EDGE registry, the mortality and morbidity risks of MV surgery after TEER were not negligible, and only <10% of patients underwent MV repair. These registry data provide valuable insights for further research to improve these outcomes.
Zeitschriftentitel:
JACC Cardiovasc Interv
Jahr:
2021
Band / Volume:
14
Heft / Issue:
18
Seitenangaben Beitrag:
2010-2021
Volltext / DOI:
doi:10.1016/j.jcin.2021.07.029
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/34556275
Print-ISSN:
1936-8798
TUM Einrichtung:
Klinik für Herz- und Gefäßchirurgie (Prof. Lange)
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