دورية أكاديمية
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
| 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 |
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| 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 |
| بيانات النشر: | Ludwig-Maximilians-Universität München |
| سنة النشر: | 2023 |
| المجموعة: | Open Access LMU (Ludwig-Maximilians-University Munich) |
| مصطلحات موضوعية: | Medizinische Klinik und Poliklinik I (Kardiologie), ddc:610 |
| الوصف: | 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. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | Orban, Mathias ORCID logoorcid:0000-0001-7846-8808; 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 und Hausleiter, Jörg (2023): 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. In: European Journal of Heart Failure, Bd. 25, Nr. 3: S. 411-421 [PDF, 750kB]; https://epub.ub.uni-muenchen.de/108813/1/European_J_of_Heart_Fail_-_2023_-_Orban_-_Transcatheter_edge%E2%80%90to%E2%80%90edge_repair_for_secondary_mitral_regurgitation_with.pdfTest; http://nbn-resolving.de/urn:nbn:de:bvb:19-epub-108813-0Test; https://epub.ub.uni-muenchen.de/108813Test/ |
| DOI: | 10.1002/ejhf.2770 |
| الإتاحة: | https://doi.org/10.1002/ejhf.2770Test https://epub.ub.uni-muenchen.de/108813/1/European_J_of_Heart_Fail_-_2023_-_Orban_-_Transcatheter_edge%E2%80%90to%E2%80%90edge_repair_for_secondary_mitral_regurgitation_with.pdfTest https://epub.ub.uni-muenchen.de/108813Test/ http://nbn-resolving.de/urn:nbn:de:bvb:19-epub-108813-0Test |
| رقم الانضمام: | edsbas.69AF9D37 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1002/ejhf.2770 |
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