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Wild, MG; Kreidel, F; Hell, MM; Praz, F; Mach, M; Adam, M; Reineke, D; Ruge, H; Ludwig, S; Conradi, L; Rudolph, TK; Bleiziffer, S; Kellermair, J; Zierer, A; Nickenig, G; Weber, M; Petronio, AS; Giannini, C; Dahle, G; Rein, KA; Coisne, A; Vincentelli, A; Dubois, C; Duncan, A; Quarto, C; Unbehaun, A; Amat-Santos, I; Cobiella, J; Dumonteil, N; Estevez-Loureiro, R; Fumero, A; Geisler, T; Lurz, P; Mangieri, A; Monivas, V; Noack, T; Franco, LN; Pinon, MA; Stolz, L; Tchétché, D; Walter, T; Unsöld, B; Baldus, S; Andreas, M; Hausleiter, J; von Bardeleben, RS.
Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience
EUR J HEART FAIL. 2022; 24(5): 899-907. Doi: 10.1002/ejhf.2434
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Co-authors Med Uni Graz: Andreas Martin
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Abstract:: Aims Transcatheter mitral valve implantation (TMVI) is a new treatment option for patients with symptomatic mitral valve (MV) disease. Real-world data have not yet been reported. This study aimed to assess procedural and 30-day outcomes of TMVI in a real-world patient cohort. Method and results All consecutive patients undergoing implantation of a transapically delivered self-expanding valve at 26 European centres from January 2020 to April 2021 were included in this retrospective observational registry. Among 108 surgical high-risk patients included (43% female, mean age 75 +/- 7 years, mean STS-PROM 7.2 +/- 5.3%), 25% was treated for an off-label indication (e.g. previous MV intervention or surgery, mitral stenosis, mitral annular calcification). Patients were highly symptomatic (New York Heart Association [NYHA] functional class III/IV in 86%) and mitral regurgitation (MR) was graded 3+/4+ in 95% (38% primary, 37% secondary, and 25% mixed aetiology). Technical success rate was 96%, and MR reduction to <= 1+ was achieved in all patients with successful implantation. There were two procedural deaths and 30-day all-cause mortality was 12%. At early clinical follow-up, MR reduction was sustained and there were significant reductions of pulmonary pressure (systolic pulmonary artery pressure 52 vs. 42 mmHg, p < 0.001), and tricuspid regurgitation severity (p = 0.013). Heart failure symptoms improved significantly (73% in NYHA class I/II, p < 0.001). Procedural success rate according to MVARC criteria was 80% and was not different in patients treated for an off-label indication (74% vs. 81% for off- vs. on-label, p = 0.41). Conclusion In a real-world patient population, TMVI has a high technical and procedural success rate with efficient and durable MR reduction and symptomatic improvement.
Find related publications in this database (Keywords): Mitral valve disease; Mitral regurgitation; Transcatheter mitral valve implantation; Tendyne