Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience.
Aged
Aged, 80 and over
Cardiac Catheterization
/ methods
Female
Heart Failure
/ etiology
Heart Valve Diseases
/ etiology
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
/ methods
Humans
Male
Mitral Valve
/ diagnostic imaging
Mitral Valve Insufficiency
Retrospective Studies
Treatment Outcome
Mitral regurgitation
Mitral valve disease
Tendyne
Transcatheter mitral valve implantation
Journal
European journal of heart failure
ISSN: 1879-0844
Titre abrégé: Eur J Heart Fail
Pays: England
ID NLM: 100887595
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
27
12
2021
received:
25
11
2021
accepted:
10
01
2022
pubmed:
23
1
2022
medline:
24
5
2022
entrez:
22
1
2022
Statut:
ppublish
Résumé
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. 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). In a real-world patient population, TMVI has a high technical and procedural success rate with efficient and durable MR reduction and symptomatic improvement.
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
899-907Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
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