Transcatheter Structural Heart Interventions for the Treatment of Chronic Heart Failure

Trigo, María Del; Rodés‐Cabau, Josep

doi:10.1161/circinterventions.114.001943

Cited by 9 publications

(11 citation statements)

References 59 publications

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“…5 Consequently, the rising incidence of MR, coupled with the aging populations, has led to a growing population of elderly patients with mitral valve disease (MVD) who may be high-risk candidates for SMVR. 7 Therefore, percutaneous therapy for MVD has become a target for investigators to improve care for patients at high surgical risk with inadequate response to medical therapy. 8 Hospital readmissions commonly represent preventable adverse events and have been shown to correlate with both patient morbidity and rising healthcare expenditures across multiple disease processes.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the prevalence of MR increases with age, with significantly higher rates in the elderly population (0.5% [18−44] vs. 10% [≥75 years]) 5 . Consequently, the rising incidence of MR, coupled with the aging populations, has led to a growing population of elderly patients with mitral valve disease (MVD) who may be high‐risk candidates for SMVR 7 . Therefore, percutaneous therapy for MVD has become a target for investigators to improve care for patients at high surgical risk with inadequate response to medical therapy 8 …”

Section: Introductionmentioning

confidence: 99%

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Impact of sex on in‐hospital mortality and 90‐day readmissions in patients undergoing transcatheter mitral valve replacement (TMVR): Analysis from the nationwide readmission database

Ismayl

Balakrishna

Elgayesh

et al. 2023

Cathet Cardio Intervent

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Objectives: To evaluate sex differences in in-hospital mortality and 90-day readmission rates among patients undergoing transcatheter mitral valve replacement (TMVR) in the United States of America.Background: Women have higher rates of mortality and rehospitalization than men following many cardiac procedures. TMVR has grown as an alternative to mitral valve surgery for patients at high surgical risk. The rates of TMVR mortality and rehospitalization by sex are unknown. Methods:We analyzed the Nationwide Readmissions Database (NRD) from 2016 to 2019 to identify hospitalizations for TMVR. Sex differences in in-hospital mortality and 90-day readmissions were determined using logistic regression models.Results: Between 2016 and 2019, 4109 hospitalizations for TMVR were identified, comprised of 1758 (42.8%) men and 2351 (57.2%) women. The median age was 74 years for both men and women. There was no significant difference in in-hospital mortality during index hospitalization (6.51% vs. 6.69%; p = 0.852) and all-cause 90-day readmission (28.19% vs. 29.59%; p = 0.563) between men and women.Across the study period, trend analysis did not reveal a significant change in inhospital mortality (men p = 0.087, women p = 0.194) or 90-day readmission rates (men p = 0.569, women p = 0.454). Conclusions:In patients undergoing TMVR, in-hospital mortality and 90-day readmissions are similar between men and women. Between 2016 and 2019, TMVR in-hospital mortality and 90-day readmission rates remained unchanged.Further research is necessary to confirm these findings.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of sex on in‐hospital mortality and 90‐day readmissions in patients undergoing transcatheter mitral valve replacement (TMVR): Analysis from the nationwide readmission database

Ismayl

Balakrishna

Elgayesh

et al. 2023

Cathet Cardio Intervent

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“…7 However, left heart-assisted devices such as implantable cardioverter defibrillators and Cardiac Resynchronization Therapy-Defibrillators have been used to treat HFrEF patients who are inadequately controlled by pharmacotherapy, their clinical application is rather limited. 8 Over recent years, atrial shunt devices have been used for the treatment of chronic heart failure, but there remains a lack of clinical experience. [9][10][11][12][13] Hence, the aim of the present study was to report the first application of the atrial shunt device D-shant in the treatment of 6 patients and provide clinical basis for the application of new atrial shunt device.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, some assistive devices have appeared in addition to standardized drug therapy, including implantable cardioverter defibrillator 6 and cardiac resynchronization therapy 7 . However, left heart‐assisted devices such as implantable cardioverter defibrillators and Cardiac Resynchronization Therapy‐Defibrillators have been used to treat HFrEF patients who are inadequately controlled by pharmacotherapy, their clinical application is rather limited 8 . Over recent years, atrial shunt devices have been used for the treatment of chronic heart failure, but there remains a lack of clinical experience 9–13 .…”

Section: Introductionmentioning

confidence: 99%

Clinical study on the treatment of chronic heart failure with a novel D‐shant atrium shunt device

et al. 2022

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Background Atrial septal shunt devices might improve hospitalizations and also prognosis in heart failure with increased pulmonary pressures due to left heart diseases. In recent years, atrial shunt devices have been used for the treatment of chronic heart failure, but there remains a lack of clinical experience. This study aimed to analyse the therapeutic effect of a novel type of atrial shunt on chronic heart failure. Methods and results From May 2020 to September 2020, six patients who were diagnosed with chronic heart failure and completed percutaneous D‐shant atrium shunt device implantation in the Department of Cardiovascular Surgery, Union Hospital, were retrospectively included. The shunt location was evaluated by echocardiography and digital subtraction angiography. Heart function was evaluated by New York Heart Association functional class. Echocardiography was used to measure the diameter of the new chamber and ventricle, and to evaluate the degree of mitral and tricuspid regurgitation. Before operation and 6 months after operation, left atrial end‐diastolic volume, right atrial end‐diastolic volume, left ventricular end‐diastolic volume, and right ventricular end‐diastolic volume were measured by magnetic resonance imaging. Left ventricular ejection fractions and right ventricular ejection fractions were calculated. Haemodynamic indexes of right heart catheterization and clinical cardiac function indexes were collected and compared before and 6 months after shunt implantation. All six patients completed percutaneous shunt device implantation. Echocardiography and digital subtraction angiography showed that the shunt device was correctly positioned and unobstructed in all patients. Echocardiography revealed that the left ventricular diameter decreased significantly from 6.40 ± 0.57 mm to 5.03 ± 0.73 mm (P < 0.05). There was an obvious decrease in mitral regurgitation. Magnetic resonance imaging showed a reduction in the volume of the left ventricle (182.00 ± 27.02 mL vs. 125.75 ± 16.11 mL, P < 0.05). Cardiac catheter examination showed the mean left atrium pressure or pulmonary capillary wedge pressure decreased postoperatively (31.83 ± 11.55 vs. 18.00 ± 5.51 mmHg, P < 0.05). There was also obvious improvement in clinical indicators of cardiac function at 6 months after implantation. Conclusions This novel D‐shant atrium shunt device revealed maintained good function, no dislodgement and no paradoxical emboli. After implantation, functional mitral regurgitation in all patients with heart failure with reduced ejection fraction improved.

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“… 4 Consequently, the increasing incidence of MR, coupled with the aging populations in developed countries, has led to a growing population of elderly patients with mitral valve disease (MVD) who may be high‐risk candidates for surgical mitral valve interventions. 6 Therefore, percutaneous therapies, including mitral transcatheter edge‐to‐edge repair (M‐TEER; MitraClip, Abbott, Chicago, IL) and transcatheter mitral valve replacement (TMVR), were developed as therapeutic options in patients with MVD. 7 …”

mentioning

confidence: 99%

Racial and Ethnic Disparities in the Use and Outcomes of Transcatheter Mitral Valve Replacement: Analysis From the National Inpatient Sample Database

Ismayl

Abbasi

Al-abcha

et al. 2023

JAHA

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Background Racial and ethnic disparities in outcomes exist following many cardiac procedures. Transcatheter mitral valve replacement (TMVR) has grown as an alternative to mitral valve surgery for patients at high surgical risk. The outcomes of TMVR by race and ethnicity are unknown. We aimed to evaluate racial and ethnic disparities in the outcomes of TMVR. Methods and Results We analyzed the National Inpatient Sample database from 2016 to 2020 to identify hospitalizations for TMVR. Racial and ethnic disparities in TMVR outcomes were determined using logistic regression models. Between 2016 and 2020, 5005 hospitalizations for TMVR were identified, composed of 3840 (76.7%) White race, 505 (10.1%) Black race, 315 (6.3%) Hispanic ethnicity, and 345 (6.9%) from other races (Asian, Pacific Islander, American Indian or Alaska Native, Other). Compared with other racial and ethnic groups, Black patients were significantly younger and more likely to be women (both P <0.01). There were no significant differences between White, Black, and Hispanic patients in in‐hospital mortality (5.2% versus 5.0% versus <3.5%; P =0.89) and procedural complications, including heart block ( P =0.91), permanent pacemaker ( P =0.49), prosthetic valve dysfunction ( P =0.45), stroke ( P =0.37), acute kidney injury ( P =0.32), major bleeding ( P =0.23), and blood transfusion ( P =0.92), even after adjustment for baseline characteristics. Adjusted vascular complications were higher in Black compared with White patients ( P =0.03). Trend analysis revealed a significant increase in TMVR in all racial and ethnic groups from 2016 to 2020 ( P trend <0.05). Conclusions Between 2016 and 2020, Black and Hispanic patients undergoing TMVR had similar in‐hospital outcomes compared with White patients, except for higher vascular complications in Black patients. Further comparative studies of TMVR in clinically similar White patients and other racial and ethnic groups are warranted to confirm our findings.

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Transcatheter Structural Heart Interventions for the Treatment of Chronic Heart Failure

Cited by 9 publications

References 59 publications

Impact of sex on in‐hospital mortality and 90‐day readmissions in patients undergoing transcatheter mitral valve replacement (TMVR): Analysis from the nationwide readmission database

Impact of sex on in‐hospital mortality and 90‐day readmissions in patients undergoing transcatheter mitral valve replacement (TMVR): Analysis from the nationwide readmission database

Clinical study on the treatment of chronic heart failure with a novel D‐shant atrium shunt device

Racial and Ethnic Disparities in the Use and Outcomes of Transcatheter Mitral Valve Replacement: Analysis From the National Inpatient Sample Database

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