Open AccessPrevious TAVR in patients undergoing percutaneous edge-to-edge mitral valve repair (PMVR) affects improvement of MR
Author(s) -
Johannes Patzelt,
Miriam Ulrich,
Annika Becker,
Karin Müller,
Rezo Jorbenadze,
Michal Droppa,
Wenzhong Zhang,
Sarah Mandel,
Lisa Habel,
Henning Lausberg,
Janine Pöss,
Tobias Geisler,
Oliver Borst,
Peter Rosenberger,
Christian Schlensak,
Meinrad Gawaz,
Jürgen Schreieck,
Peter Seizer,
Harald Langer
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0205930
Subject(s) - mitraclip , medicine , mitral regurgitation , valve replacement , cardiology , cohort , ejection fraction , prospective cohort study , mitral valve , mitral valve repair , percutaneous , heart failure , stenosis
Background Patients after transcatheter aortic valve replacement (TAVR) and persistent severe mitral regurgitation (MR) are increasingly treated with percutaneous edge-to-edge mitral valve repair (PMVR). The impact of a former TAVR on PMVR procedures is not clear. Methods and results We retrospectively analyzed 332 patients undergoing PMVR using the MitraClip system with respect to procedural and clinical outcome. 21 of these 332 patients underwent TAVR before PMVR. Intra-procedural transthoracic (TTE) and transesophageal echocardiograms (TEE) immediately before and after clip implantation as well as invasive hemodynamic measurements were evaluated. At baseline, we found a significantly smaller mitral valve anterior-posterior diameter in the TAVR cohort (p < 0.001). A reduction of MR by at least three grades was achieved in a smaller fraction in the TAVR cohort as compared to the cohort with a native aortic valve (p = 0.02). Accordingly, we observed a smaller post-procedural cardiac output in the TAVR cohort (p = 0.02). Conclusion PMVR in patients who had a TAVR before, is associated with altered MR anatomy before and a reduced improvement of MR after the procedure. Future larger and prospective studies will have to determine, whether a previous TAVR influences long-term clinical outcome of patients undergoing PMVR.