التفاصيل البيبلوغرافية
| العنوان: |
Transcatheter edge‐to‐edge repair for secondary mitral regurgitation with third‐generation devices in heart failure patients – results from the Global EXPAND Post‐Market study. |
| المؤلفون: |
Orban, Mathias, Rottbauer, Wolfgang, Williams, Mathew, Mahoney, Paul, von Bardeleben, Ralph Stephan, Price, Matthew J., Grasso, Carmelo, Lurz, Philipp, Zamorano, Jose L., Asch, Federico M., Maisano, Francesco, Kar, Saibal, Hausleiter, Jörg |
| المصدر: |
European Journal of Heart Failure; Mar2023, Vol. 25 Issue 3, p411-421, 11p, 6 Charts, 3 Graphs |
| مصطلحات موضوعية: |
MITRAL valve insufficiency, HEART failure patients, MITRAL valve, CLINICAL trials, HEART failure, HEART assist devices |
| مستخلص: |
Aims: Mitral valve transcatheter edge‐to‐edge repair is a guideline‐recommended treatment option for patients with secondary mitral regurgitation (SMR). The purpose of this analysis was to report contemporary real‐world outcomes in SMR patients treated with third‐generation MitraClip systems. Methods and results: EXPAND is a prospective, multicentre, international, single‐arm study with 1041 patients treated for mitral regurgitation (MR) with MitraClip NTR/XTR, with 30‐day and 1‐year follow‐up. All echocardiograms were analysed by an independent echocardiographic core lab. Study outcomes included procedural outcomes, durability of MR reduction, and major adverse events including all‐cause mortality and heart failure hospitalizations (HFH). A subgroup of 413 symptomatic patients (age 74.7 ± 10.1 years, 58% male) with severe SMR were included. MR reduction to MR ≤ 1+ and MR ≤ 2+ was achieved in 93.0% and 98.5% of patients, respectively, which was sustained at 1‐year follow‐up. All‐cause mortality was 17.7% at 1‐year‐ follow‐up, and the combined endpoint of all‐cause mortality or first HFH occurred in 34% of patients. This combined endpoint was significantly less frequently observed in MR ≤ 1+ patients (Kaplan–Maier estimates: 29.7% vs. 69.6% for MR ≤ 1+ vs. MR ≥ 2 +; p < 0.0001). New York Heart Association (NYHA) functional class improved significantly from baseline (NYHA ≤ II: 17%) to 1‐year follow‐up (NYHA ≤ II: 78%) (p < 0.0001). While MR reduction was comparable between NTR‐only vs. XTR‐only treated patients, less XTR clips were required for achieving MR reduction. Conclusions: Under real‐world conditions, optimal sustained MR reduction to MR ≤ 1+ was achieved in a high percentage of patients with third‐generation MitraClip, which translated into symptomatic improvement and low event rates. These results appear to be comparable with recent randomized clinical trials. [ABSTRACT FROM AUTHOR] |
|
Copyright of European Journal of Heart Failure is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder