Author + information
- Wen–Loong Yeow,
- Takashi Matsumoto,
- Robert Siegel,
- Asma Hussaini,
- Mamoo Nakamura,
- Moody Makar,
- Amin Manuchehry,
- Rehan Kanji,
- Alfredo Trento and
- Saibal Kar
It has been previously shown that percutaneous repair with the MitraClip for significant mitral regurgitation (MR) is associated with acute post procedure improvements in cardiac output (CO) in majority of patients. Little is known about the clinical benefits of these acute hemodynamic improvements.
Matched hemodynamic data was available for 152 of 154 consecutive patients treated with one or more MitraClip(s) in a single center. Patients without CO improvement were compared with those that did for differences in primary composite outcome (all cause mortality, reintervention, and hospitalization for heart failure).
26 (17%) patients had no improvement of CO. 126(83%) had a 35% increase in CO. At a median follow–up of 12 months, these patients had a lower Kaplan–Meier estimate of primary composite outcome (52% vs 78% with improve CO, p=0.014), mainly attributed to reintervention (19% vs 3% with improve CO, p=0.002). There was no difference in actuarial mortality (89% vs 91%, p=0.89). On multivariate analysis, no improvement in CO (odd ratio 2.27, 95% confidence interval (CI): 1.35 to 3.82; p=0.002) and baseline left ventricular end systolic diameter (odds ratio 1.08, 95% CI 1.01 to 1.16; p=0.035) were predictors of composite primary endpoint.
The failure of an improvement in acute CO is a strong predictor of primary composite outcome at one year.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Evolving Concepts for the Optimal Management of Mitral Regurgitation from E–Clip to Robotics
Abstract Category: 32. Valvular Heart Disease: Therapy
Presentation Number: 1111–78
- 2013 American College of Cardiology Foundation