Is Surgical or Catheter-based Interventions an Option After an Unsuccessful Mitral Clip?

作者: Felix Kreidel , Hannes Alessandrini , Peter Wohlmuth , Michael Schmoeckel , Stephan Geidel

DOI: 10.1053/J.SEMTCVS.2018.03.005

关键词:

摘要: The objective of this study was to assess the results catheter-based and surgical reinterventions in primary mitral regurgitation after failed MitraClip therapy. We report on 21 consecutive symptomatic patients with (median age 78 years) who underwent either repeat therapy (n = 7) or valve surgery (n = 14) failure index procedure 1-2 implantations. At time reinterventions, 193 (interquartile range [IQR]: 32-622) days procedure, had recurrent persistent grade 3 regurgitation. Early mortality at 30 4.8%. Cardiac-related survival 2 years 85.4% (4 cardiac 4 noncardiac deaths). Three 7 percutaneous reintervention were converted 34, 52, 56 because ineffective pre-existing clip detachment leaflet tear. Final biological replacement 14 (66.7%); treated repair (19%), patients, repairs performed (14.3%). follow-up a median 708 days, New York Heart Association class improved significantly (IQR: 1.0-2.5) (P = 0.0004), left ventricular end-diastolic diameter decreased from 52-59) mm 51 (48-58) mm (P = 0.0378), respectively. Recurrence significant absent all but 1 patient unsuccessful deemed inoperable. Our data show that both also are feasible safe alternatives without an excessively increased perioperative risk. conclude whenever insertion is not compromised, reasonable redo concept; remaining cases, should be offered patient.

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