17e397ef55b0ab13a643affc9d44cc23 269925.pdf cf890348a9b56fab98ac09b2168aa1d85c2ce31f 269925.pdf 1b1b24fe65e0c7423cc3e4646c84fb8676a6b4a0811c1b28de7bfb638c38ee38 269925.pdf Title: Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device Subject: Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system. Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017. The cohort was divided into three groups according to the use of the first-generation Mitraclip during the first (control-1) or second half (control-2) or the Mitraclip NT system. Results: A total of 545 consecutive patients were included in the study. Among all, 182 (33.3%), 183 (33.3%), and 180 (33.3%) patients underwent mitral repair in the control-1, control-2, and NT cohorts, respectively. Procedural success was achieved in 93.3% of patients without differences between groups. Major adverse events did not statistically differ among groups, but there was a higher rate of pericardial effusion in the control-1 group (4.3%, 0.6%, and 2.6%, respectively; p = 0.025). The composite endpoint of death, surgery, and admission for congestive heart failure (CHF) at 12 months was lower in the NT group (23.5% in control-1, 22.5% in control-2, and 8.3% in the NT group; p = 0.032). Conclusions: The present paper shows that contemporary clinical outcomes of patients undergoing PMVR with the Mitraclip system have improved over time. Keywords: transcatheter mitral valve repair; mitral regurgitation; MitraClip Author: Xavier Freixa, Rodrigo Estévez-Loureiro, Fernando Carrasco-Chinchilla, Xavier Millán, Ignacio Amat-Santos, Ander Regueiro, Luis Nombela-Franco, Isaac Pascual, Belen Cid, José Ramón López-Mínguez, Rosa Ana Hernández-Antolín, Ignacio Cruz-González, Leire Andraka, Javier Goicolea, Valeriano Ruíz-Quevedo, Jose Luís Díez, Alberto Berenguer, José Antonio Baz, Manuel Pan, Tomas Benito-González, Juan H. Alonso Briales, Chi Hion Li, Laura Sanchis, Ana Serrador, Pilar Jiménez-Quevedo, Pablo Avanzas, Luisa Salido, Felipe Fernández-Vázquez, José Maria Hernández-García and Dabit Arzamendi Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Feb 22 07:31:13 2021 CET ModDate: Mon Feb 22 07:37:24 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3968448 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YRGTDM+URWPalladioL-Ital Type 1 Custom yes yes no 10 0 HJOFVR+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 SKNRKX+URWPalladioL-Roma Type 1 Custom yes yes no 19 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 23 0 DUFXDP+VnURWPalladioL Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 TNBSFT+CMSY10 Type 1 Builtin yes yes no 84 0 WVWPDJ+PazoMath-Italic Type 1 Builtin yes yes no 88 0 FAECIJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 95 0 FNTSBS+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 110 0 FNTSBS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 116 0 FNTSBS+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 122 0 FNTSBS+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 137 0 FNTSBS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 143 0 FNTSBS+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 149 0 FNTSBS+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 161 0 FNTSBS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 167 0 FNTSBS+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 173 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-27 03:13:20 CEST RepresentationInformation: 269925.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-03-31 12:04:47 CEST Size: 3968448 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 293 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Study Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Post-Procedural Care Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Endpoints and Definitions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Clinical Follow-Up Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Echocardiographic Follow-Up Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Info: Title: Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device Author: Xavier Freixa, Rodrigo Estévez-Loureiro, Fernando Carrasco-Chinchilla, Xavier Millán, Ignacio Amat-Santos, Ander Regueiro, Luis Nombela-Franco, Isaac Pascual, Belen Cid, José Ramón López-Mínguez, Rosa Ana Hernández-Antolín, Ignacio Cruz-González, Leire Andraka, Javier Goicolea, Valeriano Ruíz-Quevedo, Jose Luís Díez, Alberto Berenguer, José Antonio Baz, Manuel Pan, Tomas Benito-González, Juan H. Alonso Briales, Chi Hion Li, Laura Sanchis, Ana Serrador, Pilar Jiménez-Quevedo, Pablo Avanzas, Luisa Salido, Felipe Fernández-Vázquez, José Maria Hernández-García and Dabit Arzamendi Subject: Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system. Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017. The cohort was divided into three groups according to the use of the first-generation Mitraclip during the first (control-1) or second half (control-2) or the Mitraclip NT system. Results: A total of 545 consecutive patients were included in the study. Among all, 182 (33.3%), 183 (33.3%), and 180 (33.3%) patients underwent mitral repair in the control-1, control-2, and NT cohorts, respectively. Procedural success was achieved in 93.3% of patients without differences between groups. Major adverse events did not statistically differ among groups, but there was a higher rate of pericardial effusion in the control-1 group (4.3%, 0.6%, and 2.6%, respectively; p = 0.025). The composite endpoint of death, surgery, and admission for congestive heart failure (CHF) at 12 months was lower in the NT group (23.5% in control-1, 22.5% in control-2, and 8.3% in the NT group; p = 0.032). Conclusions: The present paper shows that contemporary clinical outcomes of patients undergoing PMVR with the Mitraclip system have improved over time. Keywords: transcatheter mitral valve repair; mitral regurgitation; MitraClip Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Feb 22 07:31:13 CET 2021 ModDate: Mon Feb 22 07:37:24 CET 2021 ID: 0x226392f3a105eff54b847aecd87f240d, 0x226392f3a105eff54b847aecd87f240d Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: SKNRKX+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: SKNRKX+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TNBSFT+CMSY10 FontSubset: true FirstChar: 6 LastChar: 21 FontDescriptor: FontName: TNBSFT+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: JYPLJJ+VnURWPalladioL-Bold FontSubset: true FirstChar: 161 LastChar: 226 FontDescriptor: FontName: JYPLJJ+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: 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