05bc9c48203e010d1ff3249344caea56 324417.pdf a0c1154d53de727d1f924598d3cc261a29288aa6 324417.pdf 2d010f3e6bd5fdb484729fa3d31c635d471e42039e0149f27d2c0e0565bd945d 324417.pdf Title: Combined Use of MITRACLIP and Ventricular ASSIST Devices in Cardiogenic Shock: MITRA-ASSIST Registry Subject: Background: Patients with cardiogenic shock (CS) and mitral regurgitation (MI) have a prohibitive risk that contraindicates surgical treatment. Although the feasibility of transcatheter edge-to-edge therapy (TEER) has been demonstrated in this setting, the benefit of the combined use of TEER with mechanical circulatory support devices (MCS) has not been studied. The aim of this study was to evaluate the clinical outcomes of TEER in patients with MCS. Methods: The MITRA-ASSIST study is a retrospective multicentre Spanish registry that included patients with MR and CS who underwent TEER in combination with MCS. The primary endpoint was death from any cause at 12 months. The secondary endpoint was a composite of death from any cause or hospitalisation for heart failure at 12 months. Results: A total of twenty-four patients in nine high-volume Spanish centres (66.2 (51–82) years, 70.8% female, EuroSCORE II 20.4 17.8) were included. Acute ST-elevation myocardial infarction was the main CS aetiology (56%), and the most implanted MCS was the intra-aortic balloon pump (82.6%), followed by ECMO (8.7%), IMPELLACP® (4.3%), or a combination of both (4.3%). Procedural success was 95.8%, with 87.5% in-hospital survival. At 12-month follow-up, 25.0% of patients died, and 33.3% had a composite event of death from any cause or hospitalisation for heart failure. Conclusions: TEER in patients with concomitant CS and MR who require MCS appears to be a promising therapeutic alternative with a high device procedural success rate and acceptable mortality and heart failure readmission rates at follow-up. Keywords: cardiogenic shock; mitral regurgitation; transcatheter edge-to-edge repair; mechanical circulatory support; heart failure Author: Borja Rivero-Santana, Alfonso Jurado-Roman, Isaac Pascual, Chi Hion Li, Pilar Jimenez, Rodrigo Estevez-Loureiro, Pedro Cepas-Guillén, Tomás Benito-González, Ana Serrador, Jose Maria De La Torre-Hernandez, Pablo Avanzas, Estefania Fernandez-Peregrina, Luis Nombela, Berenice Caneiro-Queija, Xavier Freixas, Felipe Fernandez-Vazquez, Ignacio Amat-Santos, Dae-Hyun Lee, Victor Leon, Dabit Arzamendi, Raul Moreno and Guillermo Galeote Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Sun Jul 28 08:19:05 2024 CEST ModDate: Sun Jul 28 09:05:14 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3392523 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- GIFXFT+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 IKCZVE+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 SNCVCN+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 GMAHYH+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 TNBSFT+CMSY10 Type 1 Builtin yes yes yes 32 0 ESNFFO+VnURWPalladioL Type 1 Custom yes yes yes 37 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 53 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 56 0 HNNDOM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 83 0 HNNDON+PalatinoLinotype CID TrueType Identity-H yes yes yes 86 0 HNNDOO+PalatinoLinotype TrueType WinAnsi yes yes no 92 0 HNNDPP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 95 0 HNNEGO+PalatinoLinotype TrueType MacRoman yes yes no 98 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 114 0 HNNDOM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 129 0 HNNDON+PalatinoLinotype CID TrueType Identity-H yes yes yes 132 0 HNNDOO+PalatinoLinotype TrueType WinAnsi yes yes no 138 0 HNNDPP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 141 0 HNNEGO+PalatinoLinotype TrueType MacRoman yes yes no 144 0 HNNDOM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 155 0 HNNDON+PalatinoLinotype CID TrueType Identity-H yes yes yes 158 0 HNNDOO+PalatinoLinotype TrueType WinAnsi yes yes no 164 0 HNNDPP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 167 0 HNNEGO+PalatinoLinotype TrueType MacRoman yes yes no 170 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-01-28 04:15:03 CET RepresentationInformation: 324417.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-01-27 10:06:03 CET Size: 3392523 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 325 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Population Destination: subsection.2.1 Item: Title: Definitions Destination: subsection.2.2 Item: Title: Procedure Destination: subsection.2.3 Item: Title: Echocardiographic Evaluation Destination: subsection.2.4 Item: Title: Outcomes Destination: subsection.2.5 Item: Title: Statistical Analysis Destination: subsection.2.6 Item: Title: Results Destination: section.3 Children: Item: Title: Patient Characteristics Destination: subsection.3.1 Item: Title: Shock Characteristics Destination: subsection.3.2 Item: Title: Echocardiographic Characteristics Destination: subsection.3.3 Item: Title: Procedural Features and In-Hospital Outcomes Destination: subsection.3.4 Item: Title: Mechanical Circulatory Support Destination: subsection.3.5 Item: Title: Outcomes Destination: subsection.3.6 Item: Title: Discussion Destination: section.4 Item: Title: Limitations Destination: section.5 Item: Title: Conclusions Destination: section.6 Item: Title: Appendix A Destination: appendix.A. Item: Title: References Destination: appendix.B. Info: Title: Combined Use of MITRACLIP and Ventricular ASSIST Devices in Cardiogenic Shock: MITRA-ASSIST Registry Author: Borja Rivero-Santana, Alfonso Jurado-Roman, Isaac Pascual, Chi Hion Li, Pilar Jimenez, Rodrigo Estevez-Loureiro, Pedro Cepas-Guillén, Tomás Benito-González, Ana Serrador, Jose Maria De La Torre-Hernandez, Pablo Avanzas, Estefania Fernandez-Peregrina, Luis Nombela, Berenice Caneiro-Queija, Xavier Freixas, Felipe Fernandez-Vazquez, Ignacio Amat-Santos, Dae-Hyun Lee, Victor Leon, Dabit Arzamendi, Raul Moreno and Guillermo Galeote Subject: Background: Patients with cardiogenic shock (CS) and mitral regurgitation (MI) have a prohibitive risk that contraindicates surgical treatment. Although the feasibility of transcatheter edge-to-edge therapy (TEER) has been demonstrated in this setting, the benefit of the combined use of TEER with mechanical circulatory support devices (MCS) has not been studied. The aim of this study was to evaluate the clinical outcomes of TEER in patients with MCS. Methods: The MITRA-ASSIST study is a retrospective multicentre Spanish registry that included patients with MR and CS who underwent TEER in combination with MCS. The primary endpoint was death from any cause at 12 months. The secondary endpoint was a composite of death from any cause or hospitalisation for heart failure at 12 months. Results: A total of twenty-four patients in nine high-volume Spanish centres (66.2 (51 82) years, 70.8% female, EuroSCORE II 20.4 17.8) were included. Acute ST-elevation myocardial infarction was the main CS aetiology (56%), and the most implanted MCS was the intra-aortic balloon pump (82.6%), followed by ECMO (8.7%), IMPELLACP® (4.3%), or a combination of both (4.3%). Procedural success was 95.8%, with 87.5% in-hospital survival. At 12-month follow-up, 25.0% of patients died, and 33.3% had a composite event of death from any cause or hospitalisation for heart failure. Conclusions: TEER in patients with concomitant CS and MR who require MCS appears to be a promising therapeutic alternative with a high device procedural success rate and acceptable mortality and heart failure readmission rates at follow-up. 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