المؤلفون: Tiffany Dong, Serge C. Harb, Rishi Puri

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 10 (2024)

مصطلحات موضوعية: Editorials, Mitraclip, mitral regurgitation, mitral valve repair, M‐TEER, Diseases of the circulatory (Cardiovascular) system, RC666-701

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-9980Test

الوصول الحر: https://doaj.org/article/33f4bdc95aec46fc86da388fd6bbce67Test

المؤلفون: Hiroaki Yokoyama, Tobias Friedrich Ruf, Theresa Ann Maria Gößler, Martin Geyer, Julia Zirbs, Ben Luca Schwidtal, Thomas Münzel, Ralph Stephan von Bardeleben

المصدر: Frontiers in Cardiovascular Medicine, Vol 11 (2024)

مصطلحات موضوعية: mitral regurgitation, transcatheter mitral valve repair (TMVr), mitral transcatheter edge-to-edge therapy, M-TEER, COMBO therapy, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: BackgroundThere are different types of transcatheter mitral valve repair (TMVr) currently in clinical use, including leaflet approximation, annular cinching, and restoration of the chordal apparatus of the mitral valve (MV). While the concomitant combination (COMBO) therapy of mitral transcatheter edge-to-edge repair (M-TEER) with another TMVr concept has been proven feasible, potentially offering patient-tailored treatment for severe mitral regurgitation (MR), a comparison with M-TEER alone has not been made.AimsTo evaluate the procedural and clinical outcome of COMBO therapies compared with M-TEER alone.MethodsWe included consecutive patients undergoing COMBO and M-TEER between March 2015 and April 2018 at our Heart Valve Center, while excluding patients presenting a case of redo or with previous MV surgery. Procedural outcomes and all-cause mortality were compared between COMBO therapy vs. M-TEER alone.ResultsA total of 357 patients (mean age 78.9 ± 7.0 years, 53.2% male, M-TEER n = 322, COMBO n = 35; COMBO: MitraClip and the Carillon mitral contour system n = 26, MitraClip and Cardioband n = 5, and MitraClip and NeoChord n = 4) were analyzed. Patients with COMBO therapy had larger left chamber sizes, a lower left ventricular systolic ejection fraction (LVEF; COMBO: 37.4 ± 13.8%, M-TEER: 47.9 ± 14.3%, p

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fcvm.2024.1223588/fullTest; https://doaj.org/toc/2297-055XTest

الوصول الحر: https://doaj.org/article/080c706ba7ec4c10a620906cdd13cb30Test

المؤلفون: Hiroaki Yokoyama, Tobias Friedrich Ruf, Theresa Ann Maria Gößler, Martin Geyer, Julia Zirbs, Ben Luca Schwidtal, Thomas Münzel, Ralph Stephan von Bardeleben

مصطلحات موضوعية: Cardiology, Cardiology (incl. Cardiovascular Diseases), Cardiorespiratory Medicine and Haematology not elsewhere classified, mitral regurgitation, transcatheter mitral valve repair (TMVr), mitral transcatheter edge-to-edge therapy, M-TEER, COMBO therapy

الوصف: Background There are different types of transcatheter mitral valve repair (TMVr) currently in clinical use, including leaflet approximation, annular cinching, and restoration of the chordal apparatus of the mitral valve (MV). While the concomitant combination (COMBO) therapy of mitral transcatheter edge-to-edge repair (M-TEER) with another TMVr concept has been proven feasible, potentially offering patient-tailored treatment for severe mitral regurgitation (MR), a comparison with M-TEER alone has not been made. Aims To evaluate the procedural and clinical outcome of COMBO therapies compared with M-TEER alone. Methods We included consecutive patients undergoing COMBO and M-TEER between March 2015 and April 2018 at our Heart Valve Center, while excluding patients presenting a case of redo or with previous MV surgery. Procedural outcomes and all-cause mortality were compared between COMBO therapy vs. M-TEER alone. Results A total of 357 patients (mean age 78.9 ± 7.0 years, 53.2% male, M-TEER n = 322, COMBO n = 35; COMBO: MitraClip and the Carillon mitral contour system n = 26, MitraClip and Cardioband n = 5, and MitraClip and NeoChord n = 4) were analyzed. Patients with COMBO therapy had larger left chamber sizes, a lower left ventricular systolic ejection fraction (LVEF; COMBO: 37.4 ± 13.8%, M-TEER: 47.9 ± 14.3%, p < 0.001), and a more severe MR grade (p < 0.001). There were no significant differences in the prevalence of residual MR ≧2+. However, the need for re-intervention, always employing M-TEER, was more common in the COMBO group. During a mean 3.6-year long-term follow-up, there was no significant difference of all-cause mortality between both groups (Log rank p = 0.921). Conclusions COMBO therapy may still be a beneficial therapy option for patients with severe MR who already have a more dilated left ventricle (LV), a more severe MR, and a more pronounced LV systolic dysfunction. The higher need for re-intervention in the COMBO group may signal more complex anatomies and possibly underlines the ...

العلاقة: https://figshare.com/articles/presentation/Presentation1_Outcomes_of_COMBO_therapy_for_severe_mitral_regurgitation_compared_with_transcatheter_edge-to-edge_repair_pdf/25287241Test

الإتاحة: https://doi.org/10.3389/fcvm.2024.1223588.s001Test
https://figshare.com/articles/presentation/Presentation1_Outcomes_of_COMBO_therapy_for_severe_mitral_regurgitation_compared_with_transcatheter_edge-to-edge_repair_pdf/25287241Test

المؤلفون: Nicoleta Nita, Marijana Tadic, Johannes Mörike, Michael Paukovitsch, Dominik Felbel, Mirjam Keßler, Matthias Gröger, Leonhard-Moritz Schneider, Wolfgang Rottbauer

المصدر: Journal of Clinical Medicine, Vol 13, Iss 8, p 2172 (2024)

مصطلحات موضوعية: M-TEER long-term outcome, survival trends after M-TEER, prospective register M-TEER, Medicine

الوصف: (1) Objective: We aimed to assess whether the candidate profile, the long-term outcomes and the predictors for long-term mortality after transcatheter edge-to-edge mitral valve repair (M-TEER) have changed over the last decade; (2) Methods: Long-term follow-up data (median time of 1202 days) including mortality, MACCE and functional status were available for 677 consecutive patients enrolled in the prospective MiTra Ulm registry from January 2010 to April 2019. The initial 340 patients treated in our institution before January 2016 were compared with the following 337 patients; (3) Results: Patients treated after 2016 showed significantly less ventricular dilatation (left ventricular end-systolic diameter of 43 ± 13 mm vs. 49 ± 16 mm, p < 0.007), lower systolic pulmonary pressures (50 ± 15 mmHg vs. 57 ± 21 mmHg, p = 0.01) and a lower prevalence of severe tricuspid regurgitation (27.2% vs. 47.3%, p < 0.001) at baseline than patients treated before 2016. Compared to the cohort treated before 2016, patients treated afterwards showed a significantly lower all-cause 3-year mortality (29.4% vs. 43.8%, p < 0.001) and lower MACCE (38.6% vs. 54.1%, p < 0.001), without differences for MR etiology. While severe tricuspid regurgitation and NYHA class IV remained independently associated with an increased long-term mortality over the last decade, severe left ventricular dilatation (hazard ratio, HR 2.12, p = 0.047) and severe pulmonary hypertension (HR 2.18, p = 0.047) were predictors of long-term mortality only in patients treated before 2016. (4) Conclusions: The M-TEER candidates are currently treated earlier in the course of disease and benefit significantly in terms of a better long-term survival than patients treated at the beginning of the M-TEER era.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/13/8/2172Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/4ada00eccd5a4e0d9a2de594b1ddac27Test

المؤلفون: Felix Rudolph, Johannes Kirchner, Maria Ivannikova, Vera Fortmeier, Tanja Katharina Rudolph, Kai Peter Friedrichs, Volker Rudolph, Muhammed Gerçek

المصدر: Journal of Clinical Medicine, Vol 13, Iss 2, p 484 (2024)

مصطلحات موضوعية: primary mitral regurgitation, advanced mitral regurgitation, MitraClip, PASCAL, transcatheter therapy, M-TEER, Medicine

الوصف: Both the MitraClip and PASCAL systems offer transcatheter edge-to-edge repair (TEER) solutions for mitral regurgitation. Evidence indicates a lower technical success rate for TEER in complex degenerative mitral regurgitation (DMR) cases. We conducted a retrospective analysis of patients who underwent transcatheter edge-to-edge therapy for primary mitral regurgitation with advanced anatomy, defined as mitral regurgitation effective regurgitant orifice area (MR-EROA) ≥0.40 cm 2 or large flail gap (≥5 mm) or width (≥7 mm) or Barlow’s disease, that completed follow-up after 1 year. Our criteria were met by 27 patients treated with PASCAL and 18 with MitraClip. All patients exhibited a significant, equivalent short-term reduction in MR-EROA, mitral regurgitation vena contracta diameter (MR-VCD), regurgitant volume, and clinical status. At 1 year follow-up, reductions in MR-VCD, regurgitant volume, and MR-EROA remained significant for both groups without significant differences between groups. MR-Grade ≤ 1+ was achieved in 18 (66.7%) and 10 (55.6%) patients, respectively. At follow-up, no difference in hospitalization for cardiac decompensation was observed. Overall death was similar in both groups. Our study suggests that both the PASCAL and MitraClip systems significantly reduce mitral regurgitation even in advanced degenerative diseases. Within our limited data, we found no evidence of inferior performance of the PASCAL system.

العلاقة: https://www.mdpi.com/2077-0383/13/2/484Test; https://doaj.org/toc/2077-0383Test; https://doaj.org/article/003ad7a5b163476c8548d2e5d383577dTest

الإتاحة: https://doi.org/10.3390/jcm13020484Test
https://doaj.org/article/003ad7a5b163476c8548d2e5d383577dTest

المؤلفون: Lukas Stolz, MD, Sebastian Sadoni, MD, Sven Peterss, MD, Steffen Massberg, MD, Christian Hagl, MD, Michael Näbauer, MD, Jörg Hausleiter, MD

المصدر: JACC: Case Reports, Vol 28, Iss , Pp 102086- (2023)

مصطلحات موضوعية: apical access, ELASTA, M-TEER, transcatheter electrosurgery, Tendyne, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Residual and recurrent mitral regurgitation after transcatheter edge-to-edge repair are therapeutically challenging. In the present case report, we describe a simplified, transapical electrosurgical laceration and stabilization of clip procedure that represents an alternative and direct approach for electrosurgical laceration of mitral valve leaflets enabling transcatheter mitral valve replacement for recurrent mitral regurgitation after mitral valve transcatheter edge-to-edge repair.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2666084923004229Test; https://doaj.org/toc/2666-0849Test

الوصول الحر: https://doaj.org/article/473856d4d3b84edc938191aa0684c734Test

المؤلفون: Mathias Orban, Ludwig T. Weckbach, Thomas J. Stocker, Philipp M. Doldi, Michael Näbauer, Steffen Massberg, Jörg Hausleiter, Lukas Stolz

المصدر: Journal of Clinical Medicine, Vol 13, Iss 6, p 1799 (2024)

مصطلحات موضوعية: M-TEER, mitral valve edge-to-edge repair, mitral regurgitation, heart failure, Medicine

الوصف: Mitral valve transcatheter edge-to-edge repair (M-TEER) and replacement (TMVR) have evolved as guideline-recommended treatment approaches for mitral regurgitation (MR). Even though they are supported by a growing body of evidence from either randomized trials or large registries, there are still several unsolved challenges in the field of interventional MR treatment. In the present review, we discuss the ten most important open questions regarding M-TEER and TMVR.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2077-0383/13/6/1799Test; https://doaj.org/toc/2077-0383Test

الوصول الحر: https://doaj.org/article/ddefac2792e640e1a98769ee06101afbTest

المؤلفون: Zahr, Firas, Smith, Robert L, Gillam, Linda D, Chadderdon, Scott, Makkar, Raj, von Bardeleben, Ralph Stephan, Ruf, Tobias Friedrich, Kipperman, Robert M, Rassi, Andrew N, Szerlip, Molly, Goldman, Scott, Inglessis-Azuaje, Ignacio, Yadav, Pradeep, Lurz, Philipp, Davidson, Charles J, Mumtaz, Mubashir, Gada, Hemal, Kar, Saibal, Kodali, Susheel K, Laham, Roger, Hiesinger, William, Fam, Neil P, Keßler, Mirjam, O'Neill, William W, Whisenant, Brian, Kliger, Chad, Kapadia, Samir, Rudolph, Volker, Choo, Joseph, Hermiller, James, Morse, Michael A, Schofer, Niklas, Gafoor, Sameer, Latib, Azeem, Mahoney, Paul, Kaneko, Tsuyoshi, Shah, Pinak B, Riddick, John A, Muhammad, Kamran I, Boekstegers, Peter, Price, Matthew J, Praz, Fabien, Koulogiannis, Konstantinos, Marcoff, Leo, Hausleiter, Jörg, Lim, D Scott

المصدر: Articles, Abstracts, and Reports

مصطلحات موضوعية: CLASP IID, DMR, M-TEER, MitraClip system, PASCAL system, degenerative mitral regurgitation, mitral valve transcatheter edge-to-edge repair, washington, swedish, Cardiology

الوصف: BACKGROUND: The CLASP IID (Edwards PASCAL TrAnScatheter Valve RePair System Pivotal Clinical) trial is the first randomized controlled trial comparing the PASCAL system and the MitraClip system in prohibitive risk patients with significant symptomatic degenerative mitral regurgitation (DMR). OBJECTIVES: The study sought to report primary and secondary endpoints and 1-year outcomes for the full cohort of the CLASP IID trial. METHODS: Prohibitive-risk patients with 3+/4+ DMR were randomized 2:1 (PASCAL:MitraClip). One-year assessments included secondary effectiveness endpoints (mitral regurgitation [MR] ≤2+ and MR ≤1+), and clinical, echocardiographic, functional, and quality-of-life outcomes. Primary safety (30-day composite major adverse events [MAE]) and effectiveness (6-month MR ≤2+) endpoints were assessed for the full cohort. RESULTS: Three hundred patients were randomized (PASCAL: n = 204; MitraClip: n = 96). At 1 year, differences in survival, freedom from heart failure hospitalization, and MAE were nonsignificant (P > 0.05 for all). Noninferiority of the PASCAL system compared with the MitraClip system persisted for the primary endpoints in the full cohort (For PASCAL vs MitraClip, the 30-day MAE rates were 4.6% vs 5.4% with a rate difference of -0.8% and 95% upper confidence bound of 4.6%. The 6-month MR≤2+ rates were 97.9% vs 95.7% with a rate difference of 2.2% and 95% lower confidence bound (LCB) of -2.5%, for, respectively). Noninferiority was met for the secondary effectiveness endpoints at 1 year (MR≤2+ rates for PASCAL vs MitraClip were 95.8% vs 93.8% with a rate difference of 2.1% and 95% LCB of -4.1%. The MR≤1+ rates were 77.1% vs 71.3% with a rate difference of 5.8% and 95% LCB of -5.3%, respectively). Significant improvements in functional classification and quality of life were sustained in both groups (P CONCLUSIONS: The CLASP IID trial full cohort met primary and secondary noninferiority endpoints, and at 1 year, the PASCAL system demonstrated high survival, significant MR ...

العلاقة: https://digitalcommons.providence.org/publications/8157Test; https://www.ncbi.nlm.nih.gov/pubmed/37962288Test

الإتاحة: https://digitalcommons.providence.org/publications/8157Test
https://www.ncbi.nlm.nih.gov/pubmed/37962288Test

المؤلفون: Lim, D Scott, Smith, Robert L, Gillam, Linda D, Zahr, Firas, Chadderdon, Scott, Makkar, Raj, Stephan von Bardeleben, Ralph, Kipperman, Robert M, Rassi, Andrew N, Szerlip, Molly, Goldman, Scott, Inglessis-Azuaje, Ignacio, Yadav, Pradeep, Lurz, Philipp, Davidson, Charles J, Mumtaz, Mubashir, Gada, Hemal, Kar, Saibal, Kodali, Susheel K, Laham, Roger, Hiesinger, William, Fam, Neil P, Keßler, Mirjam, O'Neill, William W, Whisenant, Brian, Kliger, Chad, Kapadia, Samir, Rudolph, Volker, Choo, Joseph, Hermiller, James, Morse, Michael A, Schofer, Niklas, Gafoor, Sameer, Latib, Azeem, Koulogiannis, Konstantinos, Marcoff, Leo, Hausleiter, Jörg

المصدر: Articles, Abstracts, and Reports

مصطلحات موضوعية: washington, swedish, CLASP IID, MitraClip system, Mitral valve transcatheter edge-to-edge repair (M-TEER), PASCAL system, Transcatheter mitral valve repair (TMVr), Cardiology, Surgery

الوصف: BACKGROUND: Severe symptomatic degenerative mitral regurgitation (DMR) has a poor prognosis in the absence of treatment, and new transcatheter options are emerging. OBJECTIVES: The CLASP IID randomized trial (NCT03706833) is the first to evaluate the safety and effectiveness of the PASCAL system compared to the MitraClip system in patients with significant symptomatic DMR. In this report, we present the primary safety and effectiveness endpoints for the trial. METHODS: Patients with 3+ or 4+ DMR at prohibitive surgical risk were assessed by a central screening committee and randomized 2:1 (PASCAL:MitraClip). Study oversight also included an echocardiographic core laboratory and a clinical events committee. The primary safety endpoint was a composite major adverse event (MAE) rate at 30 days. The primary effectiveness endpoint was the proportion of patients with MR ≤2+ at 6 months. RESULTS: A pre-specified interim analysis in 180 patients demonstrated non-inferiority of the PASCAL system vs. MitraClip system for the primary safety and effectiveness endpoints, MAE: 3.4% vs. 4.8%, MR ≤2+: 96.5% vs. 96.8%, respectively. Functional and quality-of-life outcomes significantly improved in both groups (p CONCLUSIONS: The CLASP IID trial demonstrated safety and effectiveness of the PASCAL system and met non-inferiority endpoints, expanding transcatheter treatment options for prohibitive surgical risk patients with significant symptomatic DMR.

العلاقة: https://digitalcommons.psjhealth.org/publications/6555Test; https://pubmed.ncbi.nlm.nih.gov/36121247Test/

الإتاحة: https://digitalcommons.psjhealth.org/publications/6555Test
https://pubmed.ncbi.nlm.nih.gov/36121247Test/