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Mitral Regurgitation Severity Predicts One Year Therapeutic Benefit of Tendyne Transcatheter Mitral Valve Implantation.

Badhwar, Vinay; Sorajja, Paul; Duncan, Alison; Thourani, Vinod; Schaefer, Ulrich; Grayburn, Paul; Dumonteil, Nicolas; Babaliaros, Vasilis; Garatti, Andrea; Leipsic, Jonathon; Chuang, Michael; Blanke, Philipp; Muller, David.
EuroIntervention; 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31130525

AIMS:

Longitudinal outcomes of transcatheter therapies for secondary mitral regurgitation (MR) have been variable. This study examined predictors of 1-year outcome following transcatheter mitral valve implantation (TMVI) with the Tendyne device.

METHODS AND RESULTS:

The first 100 consecutive patients with severe MR enrolled in the Tendyne CE Mark trial were examined. Multivariable analyses assessed the impact of preoperative clinical and echocardiographic characteristics on 1-year freedom from death or heart failure hospitalization (HFH). Results All 100 patients underwent Tendyne TMVI without operative mortality. Univariate analysis was performed on implanted subjects, followed by multivariate analysis in those with complete predictive variable data.Patient characteristics: 76.5% male, 60.8% NYHA III/IV, age 75.6±7.5 years and Society of Thoracic Surgeons risk of mortality of 8.5±6.1%. Increased left ventricular end-diastolic dimension was associated with 1-year Tendyne benefit following univariate analysis (OR 0.35, p=0.010). Following multivariable adjustment, only severe MR, defined by a composite of effective regurgitant orifice area ≥0.3cm2 or regurgitant volume ≥45ml, was associated with freedom from death or HFH at 1-year (OR 0.16, p=0.032).

CONCLUSIONS:

Preoperative severe MR was predictive of improved 1-year outcome following Tendyne TMVI. These results may inform a therapeutic gap for the management of secondary MR and left ventricular dilatation.
Selo DaSilva