Skip to main content
main-content

04.03.2021 | Original Paper | Ausgabe 5/2021 Open Access

Clinical Research in Cardiology 5/2021

Impact of effective regurgitant orifice area on outcome of secondary mitral regurgitation transcatheter repair

Zeitschrift:
Clinical Research in Cardiology > Ausgabe 5/2021
Autoren:
Nicole Karam, Mathias Orban, Daniel Kalbacher, Christian Butter, Fabien Praz, Edith Lubos, Marwin Bannehr, Mohammad Kassar, Aniela Petrescu, Christos Iliadis, Matthias Unterhuber, Anouk Asselin, Holger Thiele, Roman Pfister, Stephan Windecker, Philipp Lurz, Stephan von Bardeleben, Jörg Hausleiter, for the EuroSMR investigators
Wichtige Hinweise

Supplementary Information

The online version contains supplementary material available at https://​doi.​org/​10.​1007/​s00392-021-01807-0.
Nicole Karam and Mathias Orban contributed equally to this work.
Members of the “EuroSMR  registry” are listed in acknowledgement section.

Abstract

Objectives

To assess the value of effective regurgitant orifice (ERO) in predicting outcome after edge-to-edge transcatheter mitral valve repair (TMVR) for secondary mitral regurgitation (SMR) and identify the optimal cut-off for patients’ selection.

Methods

Using the EuroSMR (European Registry of Transcatheter Repair for Secondary Mitral Regurgitation) registry, that included patients undergoing edge-to-edge TMVR for SMR between November 2008 and January 2019 in 8 experienced European centres, we assessed the optimal ERO threshold associated with mortality in SMR patients undergoing TMVR, and compared characteristics and outcomes of patients according to baseline ERO.

Results

Among 1062 patients with severe SMR and ERO quantification by proximal isovelocity surface area method in the registry, ERO was < 0.3 cm2 in 575 patients (54.1%), who were more symptomatic at baseline (NYHA class ≥ III: 91.4% vs. 86.9%, for ERO < vs. ≥ 0.3 cm2; P = 0.004). There was no difference in all-cause mortality at 2-year follow-up according to baseline ERO (28.3% vs. 30.0% for ERO < vs. ≥ 0.3 cm2, P = 0.585). Both patient groups demonstrated significant improvement of at least one NYHA class (61.7% and 73.8%, P = 0.002), resulting in a prevalence of NYHA class ≤ II at 1-year follow-up of 60.0% and 67.4% for ERO < vs. ≥ 0.3 cm2, respectively (P = 0.05).

Conclusion

All-cause mortality at 2 years after TMVR does not differ if baseline ERO is < or ≥ 0.3 cm2, and both groups exhibit relevant clinical improvements. Accordingly, TMVR should not be withheld from patients with ERO < 0.3 cm2 who remain symptomatic despite optimal medical treatment, if TMVR appropriateness was determined by experienced teams in dedicated valve centres.

Unsere Produktempfehlungen

Neuer Inhalt

Print-Titel

e.Med Interdisziplinär

Kombi-Abonnement

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner*in

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Jetzt e.Med zum Sonderpreis bestellen!
Das Angebot gilt nur bis 24.10.2021

Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 5/2021

Clinical Research in Cardiology 5/2021 Zur Ausgabe

Neu im Fachgebiet Kardiologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Kardiologie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise