MP18. Echocardiographic Outcomes After Transcatheter Edge-To-Edge Repair for Mitral Valve Regurgitation
Presented During: Moderated E-Posters
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I did my medical school in Firenze, Italy.
I did My residency in Siena, Italy.
I did a three year clinical fellowship in Toronto, Canada.
I did a PhD at CARIM Maastricht University.
I am an Associate Professor at Lankenau Institute for Medical Research.
Thursday, May 4, 2023: 6:30 PM - Friday, May 5, 2023: 6:30 AM
New York Hilton Midtown
Room: Grand Ballroom Foyer
Description
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.