Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure

Medvedovsky, Anna Turyan; Haberman, Dan; Ibrahimli, Mahsati; Tonchev, Ivaylo; Rashi, Yonatan; Peretz, Alona; Shimoni, Sara; Tuvali, Ortal; Danenberg, Haim; Beeri, Rоnen; Shuvy, Mony

doi:10.3390/jcm10245849

Cited by 5 publications

(2 citation statements)

References 23 publications

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“…Although definitions varied between included studies, urgent TMVr was defined as TMVr that is carried out on patients with CS, those who have been put on inotropes and/or vasopressors or mechanical circulation support (intra-aortic balloon pump and/or extracorporeal membrane oxygenation) for their symptoms in two studies. [ 12 13 ] The primary endpoint for our meta-analysis was 30-day and 1-year mortality. Secondary endpoints included postprocedural acute kidney injury (AKI), procedural success rate, stroke, and length of hospital stay.…”

Section: Methodsmentioning

confidence: 99%

The Results of Urgent and Emergent Transcatheter Mitral Valve Repair (MitraClip®): A Comparison with Standard Elective Repair

Al-Tawil,

Sunny,

Goulden

et al. 2024

Heart Views

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Background: Mitral regurgitation (MR) is the most common valvular disease worldwide. MR has been managed surgically, with either a mitral valve replacement or repair. Percutaneous transcatheter mitral valve repair (TMVr) with MitraClip® insertion has gained wide popularity and success over medical and surgical therapy for MR. Some patients with acute MR or decompensated heart failure could benefit from urgent TMVr. This meta-analysis aims to compare clinical outcomes of urgent versus elective TMVr. Methods: We performed a study-level meta-analysis to compare the clinical outcomes of urgent versus elective TMVr using the MitraClip system. The primary endpoint outcome was all-cause mortality. Additional outcomes included procedural success, postoperative acute kidney injury (AKI), stroke, and length of in-hospital stay. Results: Overall, 30-day mortality was significantly higher in the urgent group (odds ratio [OR]: 2.74; 95% confidence interval [CI] [2.17, 3.48]; P < 0.00001; I² =0%). However, subgroup analysis of matched cohorts showed no significant difference between both groups (OR: 1.80; 95% CI [0.94, 3.46]; P = 0.08; I² =0%). One-year mortality was similar between both groups (and: 1.67; 95% CI [0.96, 2.90]; P = 0.07; I² =0%). Procedural success was similar between both groups (89.4% vs. 89.8%; P = 0.43). Postoperative AKI was significantly higher in the urgent group (OR: 4.12; 95% CI [2.87, 5.91]; P < 0.00001; I² =0%). Conclusion: Urgent TMVr should be indicated in select populations as it is considered therapeutic with acceptable outcomes therein.

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Section: Methodsmentioning

confidence: 99%

The Results of Urgent and Emergent Transcatheter Mitral Valve Repair (MitraClip®): A Comparison with Standard Elective Repair

Al-Tawil,

Sunny,

Goulden

et al. 2024

Heart Views

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“…There was also the improvement of NYHA functional class and sPAP reduction in both. This indicates that PMR could be a viable option for the treatment of patients with severe MR and ADHF [ 15 ].…”

mentioning

confidence: 99%

Percutaneous Atrio-Ventricular Valve Interventions: Contemporary Advances and Remaining Challenges

Perl

Kornowski

2022

JCM

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Management of acute decompensated valvular heart disease

Lüsebrink,

Lanz,

Kellnar

et al. 2024

European J of Heart Fail

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Worldwide, valvular heart disease (VHD) is a common cause of hospitalization for acute heart failure. In acute heart failure caused by VHD, symptoms result from rapid haemodynamic changes and subsequent decline in cardiac function, and if left untreated, leads to acute decompensation and cardiogenic shock. Current evidence remains scarce and recommendations regarding the management of acute heart failure caused by VHD are lacking in most recent international guidelines. Herein, we review the management of acute heart failure caused by VHD with a focus on transcatheter therapies and describe currently available evidence based on a systematic literature search on the following valve pathologies: (i) aortic stenosis, (ii) aortic regurgitation, (iii) mitral regurgitation, and (iv) mitral stenosis. Articles reporting outcomes following urgent or emergent valve intervention in the setting of cardiogenic shock or acute heart failure were considered. After screening a total of 2234 articles, 76 published between 1994 and 2023 were included in subsequent analysis. Based on available evidence, proposed treatment algorithms to guide optimal management of acute heart failure caused by VHD were created. As the number of patients presenting with acute heart failure caused by VHD continues to rise and outcomes following transcatheter valve interventions continue to improve, it is inevitable that minimally invasive options will play an increasingly important role in the acute setting, especially given these patients are at an increased operative risk. This review aims to present an organized approach to the complex management and interventional treatment of patients with acute heart failure caused by VHD.

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Percutaneous Mitral Valve Repair in Patients with Severe Mitral Regurgitation and Acute Decompensated Heart Failure

Cited by 5 publications

References 23 publications

The Results of Urgent and Emergent Transcatheter Mitral Valve Repair (MitraClip®): A Comparison with Standard Elective Repair

The Results of Urgent and Emergent Transcatheter Mitral Valve Repair (MitraClip®): A Comparison with Standard Elective Repair

Percutaneous Atrio-Ventricular Valve Interventions: Contemporary Advances and Remaining Challenges

Management of acute decompensated valvular heart disease

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