Acute Effect of Mitral Valve Repair on Mitral Valve Geometry

Noack, Thilo; Wittgen, Kathleen; Kiefer, Philipp; Emrich, Fabian; Raschpichler, Matthias; Eibel, Sarah; Holzhey, David; Misfeld, Martín; Mohr, Friedrich–Wilhelm; Borger, Michael A.; Ender, Joerg

doi:10.1055/s-0038-1667327

Cited by 2 publications

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The estimate of MV annular compliance originated from the observation that the MV AP diameter physiologically increases in end diastole, optimizing ventricular filling. 4 Therefore, an increased ratio of end‐systolic/end‐diastolic AP diameter might distinguish patients with reduced MV annular compliance. More important, the MV annular compliance ratio did not differ between patients with and without the presence of atrial fibrillation, precluding present heart rhythm as a potential contributing factor for this finding.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, we have previously demonstrated feasibility of the 4D MV analysis and the quantification of short‐term changes of MV geometry and function. 3 , 4 Second, although the sample size might be appropriate for the analysis of geometric MV changes, it is too small to make conclusions on clinical outcomes. Furthermore, despite the fact that lost to follow‐up was not different between the treatment cohorts, it might limit the conclusions made on clinical and echocardiographic parameters.…”

Section: Discussionmentioning

confidence: 99%

“… 3 Previous studies demonstrated that TEER using the MitraClip system (Abbott Vascular, Santa Clara, CA) significantly reduced annular dimensions throughout the cardiac cycle in both primary mitral regurgitation (PMR) and SMR, as quantified by 3‐dimensional (3D) echocardiography. 4 , 5 …”

mentioning

confidence: 99%

See 2 more Smart Citations

Short‐Term Effects of Different Transcatheter Edge‐to‐Edge Devices on Mitral Valve Geometry

Rosch,

Kösser,

Besler

et al. 2023

JAHA

Self Cite

View full text Add to dashboard Cite

Background Short‐term effects on mitral valve (MV) anatomy after transcatheter edge‐to‐edge repair using the PASCAL system remain unknown. Precise quantification might allow for an advanced analysis of predictors for mean transmitral gradients. Methods and Results Consecutive patients undergoing transcatheter edge‐to‐edge repair for secondary mitral regurgitation using PASCAL or MitraClip systems were included. Quantification of short‐term MV changes throughout the cardiac cycle was performed using peri‐interventional 3‐dimensional MV images. Predictors for mean transmitral gradients were identified in univariable and multivariable regression analysis. Long‐term results were described during 1‐year follow‐up. A total of 100 patients undergoing transcatheter edge‐to‐edge repair using PASCAL (n=50) or MitraClip systems (n=50) were included. Significant reductions of anterior‐posterior diameter, annular circumference, and area throughout the cardiac cycle were found in both cohorts ( P <0.05 for all). Anatomic MV orifice area remained larger in the PASCAL cohort in mid (2.8±1.0 versus 2.4±0.9 cm 2 ; P =0.049) and late diastole (2.7±1.1 versus 2.2±0.8 cm 2 ; P =0.036) compared with the MitraClip cohort. Besides a device‐specific profile of independent predictor of mean transmitral gradients, reduction of middiastolic anatomic MV orifice area was identified as an independent predictor in both the PASCAL ( β =−0.410; P =0.001) and MitraClip cohorts ( β =−0.318; P =0.028). At follow‐up, reduction of mitral regurgitation grade to mild or less was more durable in the PASCAL cohort (90% versus 72%; P =0.035). Conclusions PASCAL and MitraClip showed comparable short‐term effects on MV geometry. However, PASCAL might better preserve MV function and demonstrated more durable mitral regurgitation reduction during follow‐up. Identification of independent predictors for mean transmitral gradients might potentially help to guide device selection in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Short‐Term Effects of Different Transcatheter Edge‐to‐Edge Devices on Mitral Valve Geometry

Rosch,

Kösser,

Besler

et al. 2023

JAHA

Self Cite

View full text Add to dashboard Cite

show abstract

Surgical treatment of mitral regurgitation

Lawrie

2020

Current Opinion in Cardiology

View full text Add to dashboard Cite

Purpose of review Mitral repair is the best treatment for degenerative mitral regurgitation. Many patients are referred too late for optimal outcomes. The US repair vs. replacement rate is only 60–80%, at a time when the inferiority of replacement has been established. Therefore, widely used traditional techniques of repair are being reappraised. Recent findings Identification of risk factors predictive of poor early and late outcome have improved timing for surgical referral. Composite risk scores have been developed. Novel echocardiographic, cardiac MRI, and molecular level risk factors could improve timing. Analysis of factors contributing to low repair rates is also of critical importance. The role of institutional and surgeon volumes have been identified. More detailed data on the importance of dynamic function of the mitral valve have led to improved repair techniques such as intraoperative simulation of end diastole and early systole, use of expanded polytetrafluoroethylene neochords instead of leaflet resection, and dynamic instead of rigid annuloplasty. Summary Our perception of mitral regurgitation has changed from a seemingly simple condition to one of considerable complexity at multiple levels. National guidelines should be studied and followed.

show abstract

Acute Effect of Mitral Valve Repair on Mitral Valve Geometry

Cited by 2 publications

References 32 publications

Short‐Term Effects of Different Transcatheter Edge‐to‐Edge Devices on Mitral Valve Geometry

Short‐Term Effects of Different Transcatheter Edge‐to‐Edge Devices on Mitral Valve Geometry

Surgical treatment of mitral regurgitation

Contact Info

Product

Resources

About