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Titel:

Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience.

Dokumenttyp:
Article; Journal Article
Autor(en):
Wild, Mirjam G; Kreidel, Felix; Hell, Michaela M; Praz, Fabien; Mach, Markus; Adam, Matti; Reineke, David; Ruge, Hendrik; Ludwig, Sebastian; Conradi, Lenard; Rudolph, Tanja K; Bleiziffer, Sabine; Kellermair, Jörg; Zierer, Andreas; Nickenig, Georg; Weber, Marcel; Petronio, Anna Sonia; Giannini, Cristina; Dahle, Gry; Rein, Kjell A; Coisne, Augustin; Vincentelli, André; Dubois, Christophe; Duncan, Alison; Quarto, Cesare; Unbehaun, Axel; Amat-Santos, Ignacio; Cobiella, Javier; Dumonteil, Nicolas; Es...     »
Abstract:
AIMS: Transcatheter mitral valve implantation (TMVI) is a new treatment option for patients with symptomatic mitral valve (MV) disease. Real-world data have not yet been reported. This study aimed to assess procedural and 30-day outcomes of TMVI in a real-world patient cohort. METHOD AND RESULTS: All consecutive patients undergoing implantation of a transapically delivered self-expanding valve at 26 European centres from January 2020 to April 2021 were included in this retrospective observational registry. Among 108 surgical high-risk patients included (43% female, mean age 75 ± 7 years, mean STS-PROM 7.2 ± 5.3%), 25% was treated for an off-label indication (e.g. previous MV intervention or surgery, mitral stenosis, mitral annular calcification). Patients were highly symptomatic (New York Heart Association [NYHA] functional class III/IV in 86%) and mitral regurgitation (MR) was graded 3+/4+ in 95% (38% primary, 37% secondary, and 25% mixed aetiology). Technical success rate was 96%, and MR reduction to ≤1+ was achieved in all patients with successful implantation. There were two procedural deaths and 30-day all-cause mortality was 12%. At early clinical follow-up, MR reduction was sustained and there were significant reductions of pulmonary pressure (systolic pulmonary artery pressure 52 vs. 42 mmHg, p < 0.001), and tricuspid regurgitation severity (p = 0.013). Heart failure symptoms improved significantly (73% in NYHA class I/II, p < 0.001). Procedural success rate according to MVARC criteria was 80% and was not different in patients treated for an off-label indication (74% vs. 81% for off- vs. on-label, p = 0.41). CONCLUSION: In a real-world patient population, TMVI has a high technical and procedural success rate with efficient and durable MR reduction and symptomatic improvement.
Zeitschriftentitel:
Eur J Heart Fail
Jahr:
2022
Band / Volume:
24
Heft / Issue:
5
Seitenangaben Beitrag:
899-907
Volltext / DOI:
doi:10.1002/ejhf.2434
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/35064722
Print-ISSN:
1388-9842
TUM Einrichtung:
Klinik für Herz- und Gefäßchirurgie (Prof. Lange)
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