Impact of left atrial diameter on outcome in patients undergoing edge‐to‐edge mitral valve repair: results from the German TRAnscatheter Mitral valve Interventions (TRAMI) registry

Abstract

Background Left atrial (LA) dimension is a marker of disease severity and outcome in primary and secondary mitral regurgitation. In transcatheter mitral valve repair, LA enlargement might additionally impact on device handling and technical success through an altered anatomy and atrial annular dilatation.

Mitral regurgitation, edge‐to‐edge valve repair and the left atrium: one step beyond the left ventricle?

“…In this issue of the Journal, Iliadis et al 13 . shed new light on the mechanisms underlying the potential selection and treatment success of patients with MR undergoing transcatheter edge‐to‐edge repair, using data from the German TRAnscatheter Mitral valve Interventions (TRAMI) registry.…”

Predictors for procedural success and all-cause mortality in patients undergoing transcatheter mitral valve edge-to-edge repair for mitral regurgitation

“…Atrial fibrillation or absence of sinus rhythm, as indicators of impaired LA function in addition to LA dilation, are linked to worse TMVr survival [42,51,52] . Severe LA dilatation with a diameter ≥ 55 cm seems to be a highly predictive cut-off value [52] .…”

“…Atrial fibrillation or absence of sinus rhythm, as indicators of impaired LA function in addition to LA dilation, are linked to worse TMVr survival [42,51,52] . Severe LA dilatation with a diameter ≥ 55 cm seems to be a highly predictive cut-off value [52] . In contrast, improvement of LA ejection fraction from baseline to short term follow up (three to six month) is associated with lower all-cause long-term mortality [53] [ Table 1].…”

July 2020 at a glance: focus on imaging and cardiomyopathies

“…Left atrial (LA) structure and function are major determinants of outcomes in patients with HF and atrial fibrillation 15,16 . LA diameter predicted 4‐year mortality also in HF patients with mitral regurgitation treated by percutaneous repair 17 . Impaired LA strain may contribute to reduced exercise capacity 18 .…”