التفاصيل البيبلوغرافية
| العنوان: |
Initial Experience With Commercial Transcatheter Mitral Valve Repair in the United States. |
| المؤلفون: |
Sorajja, Paul1 paul.sorajja@allina.com, Mack, Michael2, Vemulapalli, Sreekanth3, Jr.Holmes, David R.4, Stebbins, Amanda3, Kar, Saibal5, Lim, D. Scott6, Thourani, Vinod7, McCarthy, Patrick8, Kapadia, Samir9, Grayburn, Paul10, Pedersen, Wesley A.1, Ailawadi, Gorav6, Holmes, David R Jr4 (AUTHOR) |
| المصدر: |
Journal of the American College of Cardiology (JACC). Mar2016, Vol. 67 Issue 10, p1129-1140. 12p. |
| مصطلحات موضوعية: |
*MITRAL valve insufficiency, *CHEMOEMBOLIZATION, *ACQUISITION of data, *HEART surgeons, *MORTALITY, *THERAPEUTICS, *MITRAL valve surgery, *CARDIAC catheterization, *COMPARATIVE studies, *PROSTHETIC heart valves, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL cooperation, *RESEARCH, *SURVIVAL, *EVALUATION research, *TREATMENT effectiveness, *RETROSPECTIVE studies, *SEVERITY of illness index, *HOSPITAL mortality, *DIAGNOSIS |
| مصطلحات جغرافية: |
UNITED States |
| مستخلص: |
Background: Transcatheter mitral valve (MV) repair with the MitraClip received approval in 2013 for the treatment of prohibitive-risk patients with primary mitral regurgitation (MR).Objectives: The aim of this study was to report the initial U.S. commercial experience with transcatheter MV repair.Methods: Data from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry on patients commercially treated with this percutaneous mitral valve repair device were analyzed.Results: Of 564 patients (56% men, median age 83 years), severe symptoms were present in 473 (86.0%). The median Society of Thoracic Surgeons Predicted Risk of Mortality scores for MV repair and replacement were 7.9% (interquartile range: 4.7% to 12.2%) and 10.0% (interquartile range: 6.3% to 14.5%), respectively. Frailty was noted in 323 patients (57.3%). Transcatheter MV repair was performed for degenerative disease, present in 90.8% of patients. Overall, MR was reduced to grade ≤2 in 93.0%. In-hospital mortality was 2.3%; 30-day mortality was 5.8%. Other 30-day events were stroke (1.8%), bleeding (2.6%), and device-related complications (1.4%). The median length of stay was 3 days (interquartile range: 1 to 6 days), with 84.0% patients discharged home. Overall, procedure success occurred in 90.6%. Variables associated with reduction in MR were end-diastolic dimension, MR severity, clip location, and case volume.Conclusions: In this study of the initial commercial U.S. experience, it was found that procedural success was achieved in approximately 91% of patients, and the majority of patients were discharged home with moderate or less MR. These data support the effectiveness of this therapy in appropriately selected high-risk patients in a commercial setting. Further study is required to determine the long-term impact of transcatheter MV repair in this patient population. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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