Author + information
- Daniel Braun,
- Michael Näbauer,
- Mathias Orban,
- Steffen Massberg and
- Joerg Hausleiter
Background: The MitraClip® system has been successfully used for patients with severe tricuspid regurgitation (TR). The aim of this analysis was to investigate the feasibility, safety and short-term durability of this system in patients with and without pacemaker leads.
Methods: Clip implantation was performed via the right femoral vein using a modified steering technique to access the tricuspid valve. Combined transesophageal and transthoracic echocardiography was used to guide the procedures. Success of the procedure was defined as reduction of at least one TR grade.
Results: 25 consecutive patients were treated for severe symptomatic TR using the MitraClip® system from March through July 2016. All patients (age: 79 ± 7 years) suffered from severe right sided heart failure (NYHA III-IV) and were deemed inoperable by the heart team (EuroScore II: 9 ± 7). 8 patients were treated for sole severe tricuspid regurgitation, while 17 patients were treated for combined mitral and tricuspid regurgitation. Out of these 25 patients 7 patients were treated despite a pacemaker lead in place.
Acute procedural success was achieved in all 18 patients without pacemaker lead (100%), the interventional procedure could be performed successfully in 6 out of 7 patients with pacemaker lead in place (86%, p=0.28).
During in hospital stay we did not observe any major adverse cardiac and cerebrovascular events.
At 30 days follow-up persistent reduction of at least one TR grade could be documented in 14 out of 16 patients (88%) without pacemaker lead, TR grade reduction has been shown in all 7 patients with pacemaker lead (100%, p>0.99).
Reduction of TR grade appeared to be associated with improvement in NYHA functional status in 15 out 16 patients (94%) without pacemaker leads and in in 5 out of 7 patients (71%, p=0.21) treated in the presence of a pacemaker lead.
Conclusions: The MitraClip®-system can be successfully used for the treatment of severe TR in selected patients with and without pacemaker leads. Further studies have to define the role of this novel treatment in this subset of patients.
Moderated Poster Contributions
Interventional Cardiology Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 12:45 p.m.-12:55 p.m.
Session Title: Frontiers in Mitral Valve Disease and Treatment
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1316M-05
- 2017 American College of Cardiology Foundation