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Influence of percutaneous mitral valve repair using the M itra C lip® system on renal function in patients with severe mitral regurgitation
Author(s) -
Rassaf Tienush,
Balzer Jan,
Rammos Christos,
Zeus Tobias,
Hellhammer Katharina,
Hall Silke v.,
Wagstaff Rabea,
Kelm Malte
Publication year - 2015
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25705
Subject(s) - medicine , mitraclip , cardiology , renal function , heart failure , mitral regurgitation , stroke volume , preload , kidney , cardiac function curve , mitral valve , kidney disease , percutaneous , ejection fraction , surgery , hemodynamics
Background: In patients with mitral regurgitation (MR), changes in cardiac stroke volume, and thus renal preload and afterload may affect kidney function. Percutaneous mitral valve repair (PMVR) with the MitraClip® system can be a therapeutic alternative to surgical valve repair. The influence of MitraClip® therapy on renal function and clinical outcome parameters is unknown. Methods and Results: Sixty patients with severe MR underwent PMVR using the MitraClip® system in an open‐label observational study. Patients were stratified according to their renal function. All clips have been implanted successfully. Effective reduction of MR by 2–3 grades acutely improved KDOQI class. Lesser MR reduction (MR reduction of 0–1 grades) led to worsening of renal function in patients with pre‐existing normal or mild (KDOQI 1–2) compared to severe (KDOQI 3–4) renal dysfunction. Reduction of MR was associated with improvement in Minnesota Living with Heart Failure Questionnaire (MLHFQ), NYHA‐stadium, and 6‐minute walk test. Conclusion: Successful PMVR was associated with an improvement in renal function. The improvement in renal function was associated with the extent of MR reduction and pre‐existing kidney dysfunction. Our data emphasize the relevance of PVMR to stabilize the cardiorenal axis in patients with severe MR. © 2014 Wiley Periodicals, Inc.