Interrelationship Between Kidney Function and Percutaneous Mitral Valve Interventions: A Comprehensive Review.


Journal

Current cardiology reviews
ISSN: 1875-6557
Titre abrégé: Curr Cardiol Rev
Pays: United Arab Emirates
ID NLM: 101261935

Informations de publication

Date de publication:
2019
Historique:
received: 18 06 2018
revised: 16 10 2018
accepted: 17 10 2018
pubmed: 27 10 2018
medline: 27 4 2019
entrez: 27 10 2018
Statut: ppublish

Résumé

Percutaneous mitral valve repair is emerging as a reasonable alternative especially in those with an unfavorable surgical risk profile in the repair of mitral regurgitation. At this time, our understanding of the effects of underlying renal dysfunction on outcomes with percutaneous mitral valve repair and the effects of this procedure itself on renal function is evolving, as more data emerges in this field. The current evidence suggests that the correction of mitral regurgitation via percutaneous mitral valve repair is associated with some degree of improvement in cardiac function, hemodynamics and renal function. The improvement in renal function was more significant for those with greater renal dysfunction at baseline. The presence of Chronic Kidney Disease (CKD) in turn has been associated with poor long-term outcomes including increased mortality and hospitalization among patients who undergo percutaneous mitral valve repair. This was true regardless of the degree of improvement in GFR post repair advanced CKD. The adverse impact of CKD on long-term outcomes was consistent across all studies and was more prominent in those with GFR<30 mL/min/1.73 m². It is clear that from these contrasting evidences of improved renal function post mitral valve repair but poor long-term outcomes including increased mortality in patients with CKD, that proper patient selection for percutaneous mitral valve repair is key. There is a need to have better-standardized criteria for patients who should qualify to have percutaneous mitral valve replacement with Mitraclip. In this new era of percutaneous mitral valve repair, much work needs to be done to optimize long-term patient outcomes.

Identifiants

pubmed: 30360746
pii: CCR-EPUB-93956
doi: 10.2174/1573403X14666181024155247
pmc: PMC6520580
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

76-82

Informations de copyright

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

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Auteurs

Kevin Bryan Lo (KB)

Department of Medicine, Einstein Medical Center, Philadelphia, PA, United States.

Sandeep Dayanand (S)

Department of Cardiology, Einstein Medical Center, Philadelphia, PA, United States.

Pradhum Ram (P)

Department of Medicine, Einstein Medical Center, Philadelphia, PA, United States.

Pradeep Dayanand (P)

University of Miami - JFK Miller School of Medicine GME Consortium, Florida, FL, United States.

Leandro N Slipczuk (LN)

Department of Cardiology, Einstein Medical Center, Philadelphia, PA, United States.

Vincent M Figueredo (VM)

Department of Cardiology, Einstein Medical Center, Philadelphia, PA, United States.
Sidney Kimmel College of Thomas Jefferson University, Philadelphia, PA, United States.

Janani Rangaswami (J)

Department of Medicine, Einstein Medical Center, Philadelphia, PA, United States.
Sidney Kimmel College of Thomas Jefferson University, Philadelphia, PA, United States.

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