Open Access
Thorac Cardiovasc Surg 2018; 66(S 01): S1-S110
DOI: 10.1055/s-0038-1627926
Oral Presentations
Sunday, February 18, 2018
DGTHG: Catheter-based Valvular Therapies - AV Valves
Georg Thieme Verlag KG Stuttgart · New York

Hemodynamic Effects of Interventional Edge-to-Edge Mitral Valve Repair in Patients with End-Stage Heart Failure Awaiting Heart Transplantation

Authors

  • N. A. Geis

    1   Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany

  • S. T. Pleger

    1   Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany

  • R. Bekeredjian

    1   Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany

  • E. Chorianopoulos

    1   Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany

  • L. Frankenstein

    1   Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany

  • A. Ruhparwar

    2   Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany

  • H. A. Katus

    1   Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany

  • P. Raake

    1   Division of Cardiology, Department of Internal Medicine III, University of Heidelberg, Heidelberg, Germany
Further Information

Publication History

Publication Date:
22 January 2018 (online)

 
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Objectives: Functional mitral regurgitation is complicating end-stage heart failure and potential heart transplantation by augmenting pulmonary artery pressures. The aim of the present study was to investigate feasibility and hemodynamic effects of interventional edge-to-edge mitral valve repair using the MitraClip device in patients with end-stage heart failure awaiting heart transplantation.

Methods: In this retrospective study, we identified 9 patients suffering from end-stage heart failure listed for heart transplantation in whom moderate-severe or severe functional mitral regurgitation was recognized and treated with interventional edge-to-edge mitral valve repair. In an as-treated analysis twenty-six patients listed for heart transplantation and presenting with moderate-severe or severe functional mitral regurgitation served as controls, 22 in the pre-MitraClip era, and 4 in the MitraClip era with failed implantation. Patients were analyzed at two separate time points: MitraClip group: pre and post procedure (follow-up: 215.2 ± 53.3days), control group: study entry with recognition of moderate-severe or severe functional mitral regurgitation or pre and post failed MitraClip attempt (follow-up: 196.6 ± 46.8 days).

Results: Endovascular mitral valve repair with the MitraClip was feasible and safe in our high-risk end-stage heart failure population. Endovascular mitral valve repair resulted in significant reduction of mitral regurgitation, left atrial diameter, pulmonary artery pressures and NYHA class and improved mixed-venous oxygen saturation. No changes in the control group were observed.

Conclusions: MitraClip implantation as “bridge-to-transplant” strategy in patients with end-stage heart failure and severe functional mitral regurgitation awaiting heart transplantation is feasible and appears to result in favorable hemodynamic effects.


No conflict of interest has been declared by the author(s).

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