Echocardiographic outcomes after transcatheter edge-to-edge repair for mitral valve regurgitation.
Presented During:
Thursday, May 4, 2023: 6:30PM - Friday, May 5, 2023: 6:30AM
New York Hilton Midtown
Posted Room Name:
Grand Ballroom Foyer
Abstract No:
MP018
Submission Type:
Abstract Submission
Authors:
Aleksander Dokollari (1), Serge Sicouri (1), John Malin (2), Ozgun Erten (3), Sandra Abramson (4), Eric M Gnall (5), Gianluca Torregrossa (6), Roberto Rodriguez (4), Scott Goldman MD (4), William A Gray (4), Basel Ramlawi (7)
Institutions:
(1) N/A, N/A, (2) Lankenau Institute for Medical Research, Wynnewood, PA, (3) Lankenau Institute for Medical Research, Wynewood, PA, (4) Lankenau Medical Center, Wynnewood, PA, (5) Department of Cardiology, Wynnewood, PA, (6) University of Chicago, Chicago, IL, (7) Lankenau Heart Institute, Wynnewood, PA
Submitting Author:
Aleksander Dokollari
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Co-Author(s):
Serge Sicouri
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John Malin
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Lankenau Institute for Medical Research
Lankenau Institute for Medical Research
Ozgun Erten
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Lankenau Institute for Medical Research
Lankenau Institute for Medical Research
Sandra Abramson
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Lankenau Medical Center
Lankenau Medical Center
Eric M Gnall
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Department of Cardiology
Department of Cardiology
Gianluca Torregrossa
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University of Chicago
University of Chicago
Roberto Rodriguez
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Lankenau Medical Center
Lankenau Medical Center
*Scott Goldman MD
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Lankenau Medical Center
Lankenau Medical Center
William A Gray
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Lankenau Medical Center
Lankenau Medical Center
*Basel Ramlawi
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Lankenau Heart Institute
Lankenau Heart Institute
Presenting Author:
Aleksander Dokollari
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Abstract:
OBJECTIVE: To analyze echocardiographic outcomes after transcatheter edge-to-edge repair (TEER) with mitral valve clip device (MitraClipTM) for mitral valve regurgitation (MR).
METHODS: All consecutive patients undergoing TEER between 03/2017-10/2021 were included in the study. Primary outcome was long-term incidence of all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE).
RESULTS: The cohort consisted of 171 consecutive patients. Mean age was 79-years (± 8.9), 85 (49.7%) were women, STS-PROM score was 7.2% (± 8.2%), and 156 (91.2%) patients presented with heart failure (91 diastolic, 31 systolic, and 34 combined). In addition, 36 (21.5%) patients had functional MR, 123 (72%) had degenerative MR and 12 (6.5%) patients had mixed MR etiology. Mean EF was 42.2% (± 16.8%), mean mitral transvalvular gradient (MTG) was 3.4 (± 3.3) mmHg, mean mitral valve area (MVA) 3.8 (± 0.8) cm², mean stroke volume 59.96 (±19.3) ml, left ventricular end-diastolic volume (LVEDV) 199.8 (±72.4) ml, left ventricular end-systolic volume (LVESV) 62.5 (±51.1) ml, left ventricular end-systolic diameter 4.56 (LVESd) (±1.7), left ventricular end-diastolic diameter (LVEDd) 5.96 (±1.35) ml, regurgitation fraction 34 (± 31.1) ml, regurgitation volume 56 (±26.9) ml, left atrial end-systolic volume (LAESV) 91.8 (±27.7) ml, left atrial area (LAE) 6.58 (±5.69) cm², right ventricular systolic pressure (RVSP) 42.2 (±16.2) mmHg, moderate/severe tricuspid valve regurgitation (TR)=80 (46.8%). Intraoperatively, mean transvalvular gradient was 3.59 (±1.76) mmHg, mean EF=48% (±14.8), 92 received 1clip, 67-2 clips, 10-3 clips, 1-4 clips. Postoperatively, mean postprocedural mitral valve gradient was 3.6 mmHg (± 1.7) and 71 (41.5%) patients had none or mild MR. Mean EF was 42.2% (± 16.8%), mean MTG 3.4 (± 3.3) mmHg, mean stroke volume 60.8 (±27.4), LVEDV 104.5 (±50) ml, LVESV was 50.1 (±34.4) ml, LVEDd was 6 (±1.5) cm, LVESd was 4.6 (±1.7), LAESV 91.35 (±4.2) ml, RVSP 38.4 (±9.2) mmHg, moderate/severe TR was 74 (43.2%). Mean LOS was 4.4 (± 7.4) days. At discharge, 75 (43.8%) patients had mild MR, 82 (47.9%) moderate MR, and 14 (8.3%) severe MR.
At 5-years follow-up, mean EF=50.8% (± 14.5) mmHg, mean MTG 5 (±3) mmHg, mean stroke volume 59.5 (±23.9) ml, LVEDD 5.7 (±1.4) cm, LVESD 4.2 (±1.8) cm.
CONCLUSIONS
Echocardiographic outcomes showed an increased EF and decreased MTG.
METHODS: All consecutive patients undergoing TEER between 03/2017-10/2021 were included in the study. Primary outcome was long-term incidence of all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE).
RESULTS: The cohort consisted of 171 consecutive patients. Mean age was 79-years (± 8.9), 85 (49.7%) were women, STS-PROM score was 7.2% (± 8.2%), and 156 (91.2%) patients presented with heart failure (91 diastolic, 31 systolic, and 34 combined). In addition, 36 (21.5%) patients had functional MR, 123 (72%) had degenerative MR and 12 (6.5%) patients had mixed MR etiology. Mean EF was 42.2% (± 16.8%), mean mitral transvalvular gradient (MTG) was 3.4 (± 3.3) mmHg, mean mitral valve area (MVA) 3.8 (± 0.8) cm², mean stroke volume 59.96 (±19.3) ml, left ventricular end-diastolic volume (LVEDV) 199.8 (±72.4) ml, left ventricular end-systolic volume (LVESV) 62.5 (±51.1) ml, left ventricular end-systolic diameter 4.56 (LVESd) (±1.7), left ventricular end-diastolic diameter (LVEDd) 5.96 (±1.35) ml, regurgitation fraction 34 (± 31.1) ml, regurgitation volume 56 (±26.9) ml, left atrial end-systolic volume (LAESV) 91.8 (±27.7) ml, left atrial area (LAE) 6.58 (±5.69) cm², right ventricular systolic pressure (RVSP) 42.2 (±16.2) mmHg, moderate/severe tricuspid valve regurgitation (TR)=80 (46.8%). Intraoperatively, mean transvalvular gradient was 3.59 (±1.76) mmHg, mean EF=48% (±14.8), 92 received 1clip, 67-2 clips, 10-3 clips, 1-4 clips. Postoperatively, mean postprocedural mitral valve gradient was 3.6 mmHg (± 1.7) and 71 (41.5%) patients had none or mild MR. Mean EF was 42.2% (± 16.8%), mean MTG 3.4 (± 3.3) mmHg, mean stroke volume 60.8 (±27.4), LVEDV 104.5 (±50) ml, LVESV was 50.1 (±34.4) ml, LVEDd was 6 (±1.5) cm, LVESd was 4.6 (±1.7), LAESV 91.35 (±4.2) ml, RVSP 38.4 (±9.2) mmHg, moderate/severe TR was 74 (43.2%). Mean LOS was 4.4 (± 7.4) days. At discharge, 75 (43.8%) patients had mild MR, 82 (47.9%) moderate MR, and 14 (8.3%) severe MR.
At 5-years follow-up, mean EF=50.8% (± 14.5) mmHg, mean MTG 5 (±3) mmHg, mean stroke volume 59.5 (±23.9) ml, LVEDD 5.7 (±1.4) cm, LVESD 4.2 (±1.8) cm.
CONCLUSIONS
Echocardiographic outcomes showed an increased EF and decreased MTG.
Mitral Conclave:
Transcatheter Mitral Valve Therapies
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