5f426cf146966494c6d3ecf95467695f 271977.pdf b122edeaae08ea1c637e9c91a4f1119534f19891 271977.pdf fbe3bde65e00426f2c71a1afde427b50a54fbb51d0b6cd4c24fa318773244771 271977.pdf Title: Safety and Feasibility of MitraClip Implantation in Patients with Acute Mitral Regurgitation after Recent Myocardial Infarction and Severe Left Ventricle Dysfunction Subject: Patients with severe mitral regurgitation (MR) after myocardial infarction (MI) have an increased risk of mortality. Transcatheter mitral valve repair may therefore be a suitable therapy. However, data on clinical outcomes of patients in an acute setting are scarce, especially those with reduced left ventricle (LV) dysfunction. We conducted a multinational, collaborative data analysis from 21 centers for patients who were, within 90 days of acute MI, treated with MitraClip due to severe MR. The cohort was divided according to median left ventricle ejection fraction (LVEF)—35%. Included in the study were 105 patients. The mean age was 71 10 years. Patients in the LVEF < 35% group were younger but with comparable Euroscore II, multivessel coronary artery disease, prior MI and coronary artery bypass graft surgery. Procedure time was comparable and acute success rate was high in both groups (94% vs. 90%, p = 0.728). MR grade was significantly reduced in both groups along with an immediate reduction in left atrial V-wave, pulmonary artery pressure and improvement in New York Heart Association (NYHA) class. In-hospital and 1-year mortality rates were not significantly different between the two groups (11% vs. 7%, p = 0.51 and 19% vs. 12%, p = 0.49) and neither was the 3-month re-hospitalization rate. In conclusion, MitraClip intervention in patients with acute severe functional mitral regurgitation (FMR) due to a recent MI in an acute setting is safe and feasible. Even patients with severe LV dysfunction may benefit from transcatheter mitral valve intervention and should not be excluded. Keywords: mitral regurgitation; percutaneous mitral valve repair; acute myocardial infarction; left ventricle dysfunction Author: Dan Haberman, Rodrigo Estévez-Loureiro, Tomas Benito-Gonzalez, Paolo Denti, Dabit Arzamendi, Marianna Adamo, Xavier Freixa, Luis Nombela-Franco, Pedro Villablanca, Lian Krivoshei, Neil Fam, Konstantinos Spargias, Andrew Czarnecki, Isaac Pascual, Fabien Praz, Doron Sudarsky, Arthur Kerner, Vlasis Ninios, Marco Gennari, Ronen Beeri, Leor Perl, Haim Danenberg, Lion Poles, Sara Shimoni, Sorel Goland, Berenice Caneiro-Queija, Salvatore Scianna, Igal Moaraf, Davide Schiavi, Claudia Scardino, Noé Corpataux, Julio Echarte-Morales, Michael Chrissoheris, Estefanía Fernández-Peregrina, Mattia Di Pasquale, Ander Regueiro, Carlos Vergara-Uzcategui, Andres Iñiguez-Romo, Felipe Fernández-Vázquez, Danny Dvir, Maurizio Taramasso and Mony Shuvy Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Thu Apr 22 09:35:48 2021 CEST ModDate: Thu Apr 22 09:40:55 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2465057 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YSVHEB+VnURWPalladioL Type 1 Custom yes yes no 10 0 ZSNCVB+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 AFFYNS+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 OUJKCB+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 IOJCNK+VnURWPalladioL-Bold 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 KOSUXD+CMSY10 Type 1 Builtin yes yes no 81 0 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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: Echocardiographic Evaluation Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: MitraClip Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Children: Item: Title: Patient Characteristics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Procedural and Safety Outcomes Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Mortality Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Follow-Up Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Info: Title: Safety and Feasibility of MitraClip Implantation in Patients with Acute Mitral Regurgitation after Recent Myocardial Infarction and Severe Left Ventricle Dysfunction Author: Dan Haberman, Rodrigo Estévez-Loureiro, Tomas Benito-Gonzalez, Paolo Denti, Dabit Arzamendi, Marianna Adamo, Xavier Freixa, Luis Nombela-Franco, Pedro Villablanca, Lian Krivoshei, Neil Fam, Konstantinos Spargias, Andrew Czarnecki, Isaac Pascual, Fabien Praz, Doron Sudarsky, Arthur Kerner, Vlasis Ninios, Marco Gennari, Ronen Beeri, Leor Perl, Haim Danenberg, Lion Poles, Sara Shimoni, Sorel Goland, Berenice Caneiro-Queija, Salvatore Scianna, Igal Moaraf, Davide Schiavi, Claudia Scardino, Noé Corpataux, Julio Echarte-Morales, Michael Chrissoheris, Estefanía Fernández-Peregrina, Mattia Di Pasquale, Ander Regueiro, Carlos Vergara-Uzcategui, Andres Iñiguez-Romo, Felipe Fernández-Vázquez, Danny Dvir, Maurizio Taramasso and Mony Shuvy Subject: Patients with severe mitral regurgitation (MR) after myocardial infarction (MI) have an increased risk of mortality. Transcatheter mitral valve repair may therefore be a suitable therapy. However, data on clinical outcomes of patients in an acute setting are scarce, especially those with reduced left ventricle (LV) dysfunction. We conducted a multinational, collaborative data analysis from 21 centers for patients who were, within 90 days of acute MI, treated with MitraClip due to severe MR. The cohort was divided according to median left ventricle ejection fraction (LVEF) 35%. Included in the study were 105 patients. The mean age was 71 10 years. Patients in the LVEF < 35% group were younger but with comparable Euroscore II, multivessel coronary artery disease, prior MI and coronary artery bypass graft surgery. Procedure time was comparable and acute success rate was high in both groups (94% vs. 90%, p = 0.728). MR grade was significantly reduced in both groups along with an immediate reduction in left atrial V-wave, pulmonary artery pressure and improvement in New York Heart Association (NYHA) class. In-hospital and 1-year mortality rates were not significantly different between the two groups (11% vs. 7%, p = 0.51 and 19% vs. 12%, p = 0.49) and neither was the 3-month re-hospitalization rate. In conclusion, MitraClip intervention in patients with acute severe functional mitral regurgitation (FMR) due to a recent MI in an acute setting is safe and feasible. Even patients with severe LV dysfunction may benefit from transcatheter mitral valve intervention and should not be excluded. 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