Academic Journal
Mitral valve‐in‐valve and valve‐in‐ring procedures: Midterm outcomes in a French nationwide registry
| Τίτλος: | Mitral valve‐in‐valve and valve‐in‐ring procedures: Midterm outcomes in a French nationwide registry |
|---|---|
| Συγγραφείς: | Le Ruz, Robin, Guérin, Patrice, Leurent, Guillaume, Leroux, Lionel, Lefevre, Thierry, Nejjari, Mohammed, Champagnac, Didier, Tchétché, Didier, Lhermusier, Thibault, Senage, Thomas, Piriou, Pierre‐Guillaume, Caussin, Christophe, Delomez, Maxence, Bonnet, Guillaume, Favereau, Xavier, Karam, Nicole, Gerbay, Antoine, Juthier, Francis, Gilard, Martine, Obadia, Jean‐Francois, Iung, Bernard, Manigold, Thibaut |
| Πηγή: | Catheterization and Cardiovascular Interventions ; volume 99, issue 6, page 1829-1838 ; ISSN 1522-1946 1522-726X |
| Στοιχεία εκδότη: | Wiley |
| Έτος έκδοσης: | 2022 |
| Συλλογή: | Wiley Online Library (Open Access Articles via Crossref) |
| Περιγραφή: | Objectives Report contemporary outcomes in patients included in the Mitragister registry and treated with transcatheter mitral valve implantation for failed surgical annuloplasty rings or deteriorated bioprosthesis. Background Midterm survival rates have been reported, but little is known about contemporary morbimortality endpoints. Methods The primary safety outcome was the technical success rate. The primary efficacy composite endpoint was a composite of cardiovascular mortality and heart failure hospitalizations. Results From 2016 to 2021, 102 patients (median age: 81 [74;84] years, 61% female, Euroscore II 11.0% [7.8;16.0]) undergoing valve‐in‐valve (ViV; n = 89) or valve‐in‐ring (ViR; n = 13) procedures were consecutively included. At baseline, ViR group patients had worse left ventricular ejection fraction (50% vs. 60%; p = 0.004) and more frequently severe regurgitation (46% vs. 15%; p = 0.014). The primary safety outcome was 95%: 77% and 98% in the ViR and ViV populations, respectively, ( p = 0.014). At intermediate follow‐up (6–12 months) clinical improvement was notable, 88% of the patients were in NYHA class ≤ II (vs. 25% at baseline; p < 0.001). At a mean follow‐up of 17.1 ± 11.0 months, the primary efficacy composite reached 27%. By multivariate analysis, paravalvular leak (PVL) was the only independent predictor (hazard ratio: 2.39, 95% confidence interval: 1.08–5.29; p = 0.031) while ViR was not found statistically associated ( p = 0.456). Conclusions This study confirms the safety and efficacy of the mitral ViV procedure. ViR patients appear at higher risk of procedural complications. The presence of PVL could be associated with markedly worse midterm prognosis. Whatever the intervention, procedural strategies to reduce PVL incidence remain to be assessed to prevent latter adverse outcomes. |
| Τύπος εγγράφου: | article in journal/newspaper |
| Γλώσσα: | English |
| DOI: | 10.1002/ccd.30161 |
| Διαθεσιμότητα: | https://doi.org/10.1002/ccd.30161 https://onlinelibrary.wiley.com/doi/pdf/10.1002/ccd.30161 https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccd.30161 |
| Rights: | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| Αριθμός Καταχώρησης: | edsbas.F1539F13 |
| Βάση Δεδομένων: | BASE |
| FullText | Text: Availability: 0 CustomLinks: – Url: https://doi.org/10.1002/ccd.30161# Name: EDS - BASE (ns324271) Category: fullText Text: View record from BASE |
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| Items | – Name: Title Label: Title Group: Ti Data: Mitral valve‐in‐valve and valve‐in‐ring procedures: Midterm outcomes in a French nationwide registry – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Le+Ruz%2C+Robin%22">Le Ruz, Robin</searchLink><br /><searchLink fieldCode="AR" term="%22Guérin%2C+Patrice%22">Guérin, Patrice</searchLink><br /><searchLink fieldCode="AR" term="%22Leurent%2C+Guillaume%22">Leurent, Guillaume</searchLink><br /><searchLink fieldCode="AR" term="%22Leroux%2C+Lionel%22">Leroux, Lionel</searchLink><br /><searchLink fieldCode="AR" term="%22Lefevre%2C+Thierry%22">Lefevre, Thierry</searchLink><br /><searchLink fieldCode="AR" term="%22Nejjari%2C+Mohammed%22">Nejjari, Mohammed</searchLink><br /><searchLink fieldCode="AR" term="%22Champagnac%2C+Didier%22">Champagnac, Didier</searchLink><br /><searchLink fieldCode="AR" term="%22Tchétché%2C+Didier%22">Tchétché, Didier</searchLink><br /><searchLink fieldCode="AR" term="%22Lhermusier%2C+Thibault%22">Lhermusier, Thibault</searchLink><br /><searchLink fieldCode="AR" term="%22Senage%2C+Thomas%22">Senage, Thomas</searchLink><br /><searchLink fieldCode="AR" term="%22Piriou%2C+Pierre‐Guillaume%22">Piriou, Pierre‐Guillaume</searchLink><br /><searchLink fieldCode="AR" term="%22Caussin%2C+Christophe%22">Caussin, Christophe</searchLink><br /><searchLink fieldCode="AR" term="%22Delomez%2C+Maxence%22">Delomez, Maxence</searchLink><br /><searchLink fieldCode="AR" term="%22Bonnet%2C+Guillaume%22">Bonnet, Guillaume</searchLink><br /><searchLink fieldCode="AR" term="%22Favereau%2C+Xavier%22">Favereau, Xavier</searchLink><br /><searchLink fieldCode="AR" term="%22Karam%2C+Nicole%22">Karam, Nicole</searchLink><br /><searchLink fieldCode="AR" term="%22Gerbay%2C+Antoine%22">Gerbay, Antoine</searchLink><br /><searchLink fieldCode="AR" term="%22Juthier%2C+Francis%22">Juthier, Francis</searchLink><br /><searchLink fieldCode="AR" term="%22Gilard%2C+Martine%22">Gilard, Martine</searchLink><br /><searchLink fieldCode="AR" term="%22Obadia%2C+Jean‐Francois%22">Obadia, Jean‐Francois</searchLink><br /><searchLink fieldCode="AR" term="%22Iung%2C+Bernard%22">Iung, Bernard</searchLink><br /><searchLink fieldCode="AR" term="%22Manigold%2C+Thibaut%22">Manigold, Thibaut</searchLink> – Name: TitleSource Label: Source Group: Src Data: Catheterization and Cardiovascular Interventions ; volume 99, issue 6, page 1829-1838 ; ISSN 1522-1946 1522-726X – Name: Publisher Label: Publisher Information Group: PubInfo Data: Wiley – Name: DatePubCY Label: Publication Year Group: Date Data: 2022 – Name: Subset Label: Collection Group: HoldingsInfo Data: Wiley Online Library (Open Access Articles via Crossref) – Name: Abstract Label: Description Group: Ab Data: Objectives Report contemporary outcomes in patients included in the Mitragister registry and treated with transcatheter mitral valve implantation for failed surgical annuloplasty rings or deteriorated bioprosthesis. Background Midterm survival rates have been reported, but little is known about contemporary morbimortality endpoints. Methods The primary safety outcome was the technical success rate. The primary efficacy composite endpoint was a composite of cardiovascular mortality and heart failure hospitalizations. Results From 2016 to 2021, 102 patients (median age: 81 [74;84] years, 61% female, Euroscore II 11.0% [7.8;16.0]) undergoing valve‐in‐valve (ViV; n = 89) or valve‐in‐ring (ViR; n = 13) procedures were consecutively included. At baseline, ViR group patients had worse left ventricular ejection fraction (50% vs. 60%; p = 0.004) and more frequently severe regurgitation (46% vs. 15%; p = 0.014). The primary safety outcome was 95%: 77% and 98% in the ViR and ViV populations, respectively, ( p = 0.014). At intermediate follow‐up (6–12 months) clinical improvement was notable, 88% of the patients were in NYHA class ≤ II (vs. 25% at baseline; p < 0.001). At a mean follow‐up of 17.1 ± 11.0 months, the primary efficacy composite reached 27%. By multivariate analysis, paravalvular leak (PVL) was the only independent predictor (hazard ratio: 2.39, 95% confidence interval: 1.08–5.29; p = 0.031) while ViR was not found statistically associated ( p = 0.456). Conclusions This study confirms the safety and efficacy of the mitral ViV procedure. ViR patients appear at higher risk of procedural complications. The presence of PVL could be associated with markedly worse midterm prognosis. Whatever the intervention, procedural strategies to reduce PVL incidence remain to be assessed to prevent latter adverse outcomes. – Name: TypeDocument Label: Document Type Group: TypDoc Data: article in journal/newspaper – Name: Language Label: Language Group: Lang Data: English – Name: DOI Label: DOI Group: ID Data: 10.1002/ccd.30161 – Name: URL Label: Availability Group: URL Data: https://doi.org/10.1002/ccd.30161<br />https://onlinelibrary.wiley.com/doi/pdf/10.1002/ccd.30161<br />https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccd.30161 – Name: Copyright Label: Rights Group: Cpyrght Data: http://onlinelibrary.wiley.com/termsAndConditions#vor – Name: AN Label: Accession Number Group: ID Data: edsbas.F1539F13 |
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