共查询到20条相似文献,搜索用时 15 毫秒
1.
Mathias Orban Martin Orban Hasema Lesevic Daniel Braun Simon Deseive Carolin Sonne Lisa Hutterer Christian Grebmer Alexander Khandoga Jürgen Pache Julinda Mehilli Heribert Schunkert Adnan Kastrati Christian Hagl Axel Bauer Steffen Massberg Peter Boekstegers Michael Nabauer Ilka Ott Jörg Hausleiter 《Journal of interventional cardiology》2017,30(3):226-233
Objectives
To determine predictors for long‐term outcome in high‐risk patients undergoing transcatheter edge‐to‐edge mitral valve repair (TMVR) for severe mitral regurgitation (MR).Background
There is no data on predictors of long‐term outcome in high‐risk real‐world patients.Methods
From August 2009 to April 2011, 126 high‐risk patients deemed inoperable were treated with TMVR in two high‐volume university centers.Results
MR could be successfully reduced to grade ≤2 in 92.1% of patients (116/126 patients). Long‐term clinical follow‐up up to 5 years (95.2% follow‐up rate) revealed a mortality rate of 35.7% (45/126 patients). Repeat mitral valve treatment (surgery or intervention) was needed in 19 patients (15.1%). Long‐term clinical improvement was demonstrated with 69% of patients being in NYHA class ≤II. In a multivariable Cox regression analysis, the post‐procedural grade of MR (hazard ratio [HR] 1.55 per grade, P = 0.035), the left ventricular ejection fraction (HR 0.58 for difference between 75th and 25th percentile, P = 0.031) and the glomerular filtration rate (HR 0.33 for 75th vs 25th percentile, P < 0.001) were independent predictors for long‐term mortality. Patients with primary MR and a post‐procedural MR grade ≤1 had the most favorable long‐term outcome.Conclusions
This study determines predictors of long‐term clinical outcome after TMVR and demonstrates that the grade of residual MR determines long‐term survival. Our data suggest that it might be of benefit reducing residual MR to the lowest possible MR grade using TMVR—especially in selected high‐risk patients with primary MR who are not considered as candidates for surgical MVR.2.
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Rodrigo Estévez-Loureiro MD PhD Mony Shuvy MD Maurizio Taramasso MD PhD Tomas Benito-Gonzalez MD Paolo Denti MD PhD Dabit Arzamendi MD PhD Marianna Adamo MD Xavier Freixa MD PhD Pedro Villablanca MD MSc Lian Krivoshei MD Neil Fam MD PhD Konstantinos Spargias MD Andrew Czarnecki MD Dan Haberman MD Yoram Agmon MD Doron Sudarsky MD Isaac Pascual MD PhD Vlasis Ninios MD Salvatore Scianna MD Igal Moaraf MD Davide Schiavi MD Michael Chrissoheris MD Ronen Beeri MD Arthur Kerner MD Estefanía Fernández-Peregrina MD Mattia Di Pasquale MD Ander Regueiro MD PhD Lion Poles MD Andres Iñiguez-Romo MD PhD Felipe Fernández-Vázquez MD PhD Francesco Maisano MD 《Catheterization and cardiovascular interventions》2021,97(6):1259-1267
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Hiroaki Yokoyama Shingo Mizuno Shigeru Saito 《Catheterization and cardiovascular interventions》2020,95(6):1230-1234
The MitraClip System is extensively used in high‐risk patients with symptomatic severe mitral regurgitation (MR). Some studies have identified complications associated with use of the MitraClip. We report the case of a 91‐year‐old woman with severe MR of a prolapsed posterior commissure. Two weeks after using the MitraClip, she developed hemolytic anemia. She was conservatively treated with blood transfusion and medical treatment; fortunately, her general condition did not deteriorate during the follow‐up period. To the best of our knowledge, this is the first report of hemolytic anemia after MitraClip implantation. 相似文献
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Eduardo Martinez-Gomez MD Angela McInerney MD Gabriela Tirado-Conte MD Jose Alberto de Agustin MD PhD Pilar Jimenez-Quevedo MD PhD Andrés Escudero MD Eduardo Pozo Osinalde MD PhD Ana Viana-Tejedor MD PhD Josebe Goirigolzarri MD PhD Luis Marroquin MD David Vivas MD PhD Carlos Ferrera MD PhD Francisco Noriega MD PhD Maria Alejandra Restrepo-Cordoba MD Nieves Gonzalo MD PhD Javier Escaned MD PhD Antonio Fernández-Ortiz MD PhD Ignacio Amat-Santos MD PhD Rodrigo Estevez-Loureiro MD PhD Carlos Macaya MD PhD Luis Nombela-Franco MD PhD 《Catheterization and cardiovascular interventions》2021,98(4):E617-E625
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Weiyi Tan Marcella Calfon Press Gentian Lluri Jamil Aboulhosn 《Catheterization and cardiovascular interventions》2020,96(2):384-388
Congenital heart disease patients, specifically with unbalanced atrioventricular septal defects and common atrioventricular valves requiring single ventricle palliation, have substantial morbidity and mortality. Atrioventricular valve regurgitation (AVVR) is associated with poor outcomes in single ventricle patients, and many of them require surgical treatment of AVVR in their lifetimes. We describe a unique case of transcatheter edge‐to‐edge valve repair using the MitraClip system (Abbott, Chicago, IL) in a single ventricle patient with severe common AVVR. 相似文献
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Six‐month outcome after transcatheter edge‐to‐edge repair of severe tricuspid regurgitation in patients with heart failure 下载免费PDF全文
Mathias Orban Christian Besler Daniel Braun Michael Nabauer Marion Zimmer Martin Orban Thilo Noack Julinda Mehilli Christian Hagl Joerg Seeburger Michael Borger Axel Linke Holger Thiele Steffen Massberg Joerg Ender Jörg Hausleiter 《European journal of heart failure》2018,20(6):1055-1062
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《Indian heart journal》2016,68(3):399-404
Mitral valve disease affects more than 4 million people in the United States. The gold standard of treatment in these patients is surgical repair or replacement of the valve with a prosthesis. The MitraClip (Abbott Vascular, Menlo Park, CA) is a new technology, which offers an alternative to open surgical repair or replacement via a minimally invasive route. We present an evidence-based clinical update that provides an overview of this technology as it relates to managing patients with significant mitral regurgitation. This review article is particularly useful to noninterventional cardiologists and interventional cardiologists who will be managing patients with this novel technology in increased volumes over the next decade but who do not perform this procedure. 相似文献
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Percutaneous edge‐to‐edge repair of the mitral valve in patients with degenerative versus functional mitral regurgitation 下载免费PDF全文
Daniel Braun MD Hasema Lesevic MD Martin Orban MD Fabian Michalk MD Petra Barthel MD Katharina Hoppe MD Carolin Sonne MD Jürgen Pache MD Julinda Mehilli MD Adnan Kastrati MD Jörg Hausleiter MD Steffen Massberg MD 《Catheterization and cardiovascular interventions》2014,84(1):137-146
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Philipp M. Doldi Isabel Brinkmann Mathias Orban Lukas Stolz Martin Orban Thomas Stocker Kornelia Loew Joscha Buech Michael Nabauer Ben Illigens Tiago Lemos Cerqueira Timo Siepmann Steffen Massberg Joerg Hausleiter Daniel Braun 《Clinical cardiology》2021,44(5):708
BackgroundTranscatheter mitral valve repair (TMVR) has shown to improve symptoms and functional capacity in patients with severe mitral valve regurgitation (MR). Novel device developments provide the technology to treat patients with complex anatomies and large coaptation gaps. Nevertheless, the question of superiority of one device remains unanswered. We aimed to compare the MitraClip XTR and MitraClip NTR system in a real world setting.HypothesisTMVR with the MitraClip XTR system is equally effective, but associated with a higher risk of leaflet injury.MethodsWe retrospectively analyzed peri‐procedural and mid‐term clinical and echocardiographic outcomes of 113 patients treated for severe MR between March 2018 and August 2019 at the University Hospital of Munich.ResultsPostprocedural MR reduction to ≤2+ was comparable in both groups (XTR: 96.1% vs. NTR: 97.6%, p = .38). There was a significant difference in a composite safety endpoint of periprocedural Major adverse cardiac and cerebrovascular events (MACCE) including leaflet injury between groups (XTR 14.6% vs. NTR 1.7%, 95% CI [2.7, 24.6], p = .012). After a median follow‐up of 8.5 (4.4, 14.0) months, durable reduction of MR was confirmed (XTR: in 91.9% vs. NTR: 96.8%, p = .31) and clinical and symptomatic improvement was comparable in both groups accordingly.ConclusionWhile efficacy was comparable in both treatment groups, patients treated with the MitraClip XTR systems showed more events of acute leaflet tear and single leaflet device attachment (SLDA). A detailed echocardiographic assessment should be done to identify risk candidates for acute leaflet injury. 相似文献
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目的 评估经导管二尖瓣夹合术(MitraClip)治疗中重度或重度二尖瓣反流患者的安全性和有效性.方法 2013年10月至2014年3月,使用MitraClip系统对10例有症状的中重度(1例)或重度(9例)二尖瓣反流患者行经导管二尖瓣修复术,分析10例患者手术即刻效果和30d随访结果.结果 10例患者的平均年龄(74±10.6)岁,功能性反流8例,器质性反流2例.所有手术均成功开展,顺利置入1个(5例)或2个(5例)MitraClip.手术即刻效果提示,5例患者二尖瓣反流下降3级,5例患者下降2级,未发生相关并发症.30d超声心动图随访提示,所有患者二尖瓣反流较术前降低≥2级,左心室射血分数(LVEF)由(40.2±11.9)%提高到(44.8±11.6)%,左心房内径和舒张期左心室内径分别由(6.4±0.5) cm和(6.1±0.8) cm缩小至(6.0±0.5) cm和(6.0±0.8) cm.所有患者的主观症状较术前有不同程度的改善,纽约心功能分级均较术前提高1级,生活质量评分和6 min步行试验分别由(0.7±0.2)和(279.0±123.0)m提高到(0.9±0.1)和(347.0±91.0)m.结论 本中心初步经验提示,经导管二尖瓣夹合术(MitraClip)可以带来超声心动图指标的改善和早期的临床获益,是安全有效的,但中远期效果有待于进一步随访. 相似文献
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Mirjam Gauri Winkel Nicolas Brugger Stephan Windecker Fabien Praz 《Catheterization and cardiovascular interventions》2020,96(3):E393-E394
Recurrent flail leaflet represents an infrequent cause of recurrent mitral regurgitation after MitraClip. This report presents a case of recurrent severe MR due to a ruptured chorda tendineae after edge‐to‐edge repair. 相似文献
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15.
Long‐term survival and preprocedural predictors of mortality in high surgical risk patients undergoing percutaneous mitral valve repair 下载免费PDF全文
Andreas S. Triantafyllis MD PhD Friso Kortlandt MD Annelies L.M. Bakker MD Martin J. Swaans MD Frank D. Eefting MD Jan A.S. van der Heyden MD PhD Martijn C. Post MD PhD Benno W.J.M. Rensing MD PhD 《Catheterization and cardiovascular interventions》2016,87(3):467-475
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Repeated MitraClip procedure in patients with recurrent MR after a successful first procedure: Limitations and outcome 下载免费PDF全文
Jonathan Curio Markus Reinthaler MD Mario Kasner MD Haitham Saleh Ali Al‐Hindwan Johan Baeckemo‐Johansson Tim Neumann MD Stephan Jacobs MD Alexander Lauten MD Ulf Landmesser MD 《Journal of interventional cardiology》2018,31(1):83-90
Objectives
The present study aimed to evaluate the outcome and potential limitations of a repeated MitraClip procedure (ReClip).Background
The MitraClip procedure has emerged as a treatment option in high surgical risk patients suffering from severe mitral regurgitation (MR). However, despite successful initial repair a significant number of patients develops severe recurrent MR.Methods
Patients undergoing a ReClip procedure in our institution were retrospectively identified. Baseline data and the procedural outcome were assessed to identify potential limitations of such procedures.Results
Fifteen out of 234 patients undergoing a mitral‐valve repair with the MitraClip device (Abbott Vascular) underwent a ReClip due to recurrent MR. In 11 patients, a MR reduction of at least one degree without causing mitral valve stenosis (trans‐mitral mean gradient ≥5 mmHg) was achieved by performing a ReClip. After 1 year, two patients developed severe recurrent MR again. Pulmonary artery pressures significantly decreased after the procedure in individuals with successful repair (MR reduction of at least one degree and mitral valve mean gradient <5 mmHg).Conclusion
A ReClip procedure may be feasible in patients with recurrent MR but the risk benefit ratio should be carefully balanced against other treatment options. 相似文献18.
Relation of mitral valve morphology to surgical repair results in patients with mitral valve prolapse: A three‐dimensional transesophageal echocardiography study 下载免费PDF全文
Mirian M. Pardi MD PhD Pablo M. A. Pomerantzeff MD PhD Roney Orismar Sampaio MD PhD Maria C. Abduch PhD Carlos M. A. Brandão MD PhD Wilson Mathias MD PhD Jr Max Grinberg MD PhD Flavio Tarasoutchi MD PhD Marcelo L. C. Vieira MD PhD 《Echocardiography (Mount Kisco, N.Y.)》2018,35(9):1342-1350
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The mitral‐to‐aortic flow‐velocity integral ratio in the real world echocardiographic evaluation of functional mitral regurgitation before and after percutaneous repair 下载免费PDF全文
Giuseppe Palmiero Luigi Ascione Carlo Briguori Guido Carlomagno Chiara Sordelli Raffaele Ascione Francesca Pisacane Vittorio Monda Sergio Severino Pio Caso 《Journal of interventional cardiology》2017,30(4):368-373
Introduction
Percutaneous mitral valve repair (PMVR) using MitraClip system has emerged as a therapeutic option for patients with functional severe mitral regurgitation (FMR) at prohibitive risk for surgery. In this setting, the echocardiographic assessment of FMR severity is challenging because the traditional echocardiographic methods have important limitations. The aim of this study was to assess the accuracy and reliability of a simple Doppler index, the mitral/aortic flow velocity integral ratio (MAVIR), to evaluate residual FMR severity after PMVR.Methods
Eighty‐five heart failure patients with functional MR and LV dysfunction (LVEF ≤ 40%) were included. FMR was quantified on the basis of traditional quantitative parameters of MR severity. MAVIR was expressed as the ratio of mitral and aortic time velocity integral (TVI) values. According to MR severity, 25 patients underwent MC implantation and at 6 months a complete echocardiographic follow‐up was performed.Results
A significant linear relationship was found between MAVIR and both VC and EROA. A MAVIR ≥1.02 identified pts with severe MR with a sensitivity of 86.7% and a specificity of 90.9%. At the 6 months echocardiographic follow‐up after the MitraClip implantation, we observed a significant reduction of LAVI, LVED and LVES volume, while LVEF improved. Furthermore, MAVIR significantly decreased its decrease showed a significant linear relationship with LAVI reduction.Conclusion
Our data show a close relationship between MAVIR and traditional indexes of MR severity in patients with FMR. This Doppler‐derived index seems applicable after PMVR where traditional echocardiographic index of MR severity shows significant limitations.20.
Giulio Falasconi MD Francesco Melillo MD Luigi Pannone MD Marianna Adamo MD Federico Ronco MD Azeem Latib MD Kusha Rahgozar MD Nazario Carrabba MD Renato Valenti MD Rodolfo Citro MD Stefano Stella MD Giacomo Ingallina MD Cristina Capogrosso MD Mara Scandroglio MD Francesco Ancona MD Cosmo Godino MD Paolo Denti MD Alessandro Castiglioni MD Michele De Bonis MD Antonio Colombo MD Laura Lupi MD Luca Branca MD Matteo Montorfano MD Eustachio Agricola MD 《Catheterization and cardiovascular interventions》2021,98(1):E163-E170