TY - JOUR
T1 - Use of edge-to-edge percutaneous mitral valve repair for severe mitral regurgitation in cardiogenic shock
T2 - A multicenter observational experience (MITRA-SHOCK study)
AU - Falasconi, Giulio
AU - Melillo, Francesco
AU - Pannone, Luigi
AU - Adamo, Marianna
AU - Ronco, Federico
AU - Latib, Azeem
AU - Rahgozar, Kusha
AU - Carrabba, Nazario
AU - Valenti, Renato
AU - Citro, Rodolfo
AU - Stella, Stefano
AU - Ingallina, Giacomo
AU - Capogrosso, Cristina
AU - Scandroglio, Mara
AU - Ancona, Francesco
AU - Godino, Cosmo
AU - Denti, Paolo
AU - Castiglioni, Alessandro
AU - De Bonis, Michele
AU - Colombo, Antonio
AU - Lupi, Laura
AU - Branca, Luca
AU - Montorfano, Matteo
AU - Agricola, Eustachio
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Objectives: The aim of this study was to evaluate the impact of edge-to-edge PMVR on short and mid-term clinical outcomes in patients with CS and severe MR. Background: Severe mitral regurgitation (MR) in the setting of cardiogenic shock (CS) is associated with three times higher risk of 1-year mortality. In refractory CS, edge-to-edge percutaneous mitral valve repair (PMVR) can be a potential therapeutic option. Methods: We retrospectively included consecutive patients with refractory CS and concomitant severe MR treated with MitraClip® system. CS was defined according to the criteria used in the SHOCK trial and procedural success according to Mitral Valve Academic Research Consortium (MVARC) criteria. The 30-day and 6-month mortality were the primary and secondary endpoints respectively. Results: Thirty-one patients (median age 73 years [interquartile range, IQR 66–78], 25.8% female), STS mortality score 37.9 [IQR 30.4–42.4]), with CS and concomitant severe MR treated with edge-to-edge PMVR were retrospectively enrolled. Procedural success was 87.1%. Thirty-day and 6-month survival rates were 78.4 and 45.2% respectively. Univariate Cox Regression Model analysis showed that procedural success was a predictor of both 30-day (HR = 0.12, 95% CI 0.03–0.55, p <.01) and 6-month survival (HR = 0.22, 95% CI 0.06–0.84, p =.027). Conclusions: Edge-to-edge PMVR in patients with CS and concomitant severe MR was associated with good procedural safety and success with acceptable short and mid-term survival rates. It could be considered a bailout option in this setting of patients.
AB - Objectives: The aim of this study was to evaluate the impact of edge-to-edge PMVR on short and mid-term clinical outcomes in patients with CS and severe MR. Background: Severe mitral regurgitation (MR) in the setting of cardiogenic shock (CS) is associated with three times higher risk of 1-year mortality. In refractory CS, edge-to-edge percutaneous mitral valve repair (PMVR) can be a potential therapeutic option. Methods: We retrospectively included consecutive patients with refractory CS and concomitant severe MR treated with MitraClip® system. CS was defined according to the criteria used in the SHOCK trial and procedural success according to Mitral Valve Academic Research Consortium (MVARC) criteria. The 30-day and 6-month mortality were the primary and secondary endpoints respectively. Results: Thirty-one patients (median age 73 years [interquartile range, IQR 66–78], 25.8% female), STS mortality score 37.9 [IQR 30.4–42.4]), with CS and concomitant severe MR treated with edge-to-edge PMVR were retrospectively enrolled. Procedural success was 87.1%. Thirty-day and 6-month survival rates were 78.4 and 45.2% respectively. Univariate Cox Regression Model analysis showed that procedural success was a predictor of both 30-day (HR = 0.12, 95% CI 0.03–0.55, p <.01) and 6-month survival (HR = 0.22, 95% CI 0.06–0.84, p =.027). Conclusions: Edge-to-edge PMVR in patients with CS and concomitant severe MR was associated with good procedural safety and success with acceptable short and mid-term survival rates. It could be considered a bailout option in this setting of patients.
KW - MitraClip®
KW - cardiogenic shock
KW - mechanical circulatory support
KW - percutaneous mitral valve repair
UR - http://www.scopus.com/inward/record.url?scp=85103949370&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103949370&partnerID=8YFLogxK
U2 - 10.1002/ccd.29683
DO - 10.1002/ccd.29683
M3 - Article
C2 - 33797142
AN - SCOPUS:85103949370
SN - 1522-1946
VL - 98
SP - E163-E170
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 1
ER -