Percutaneous mitral valve repair with the mitraclip system according to the predicted risk by the logistic EuroSCORE: Preliminary results from the German Transcatheter Mitral Valve Interventions (TRAMI) registry. Issue 4 (30th April 2014)

• Record Type: Journal Article
• Authors: Wiebe, Jens; Franke, Jennifer; Lubos, Edith; Boekstegers, Peter; Schillinger, Wolfgang; Ouarrak, Taoufik; May, Andreas E.; Eggebrecht, Holger; Kuck, Karl‐Heinz; Baldus, Stephan; Senges, Jochen; Sievert, Horst; for the German Transcatheter Mitral Valve Interventions (TRAMI) Investigators
• Is Part Of: Catheterization and cardiovascular interventions. Volume 84:Issue 4(2014:Oct. 01)
• Page Start: 591
• Page End: 598
• Publication Date: 2014-04-30
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25493
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25493-sec-0001" sec-type="section"> <title>Objective</title> <p>To evaluate in‐hospital and short‐term outcomes of percutaneous mitral valve repair according to patients' logistic EuroSCORE (logEuroSCORE) in a multicenter registry</p> </sec> <sec id="ccd25493-sec-0002" sec-type="section"> <title>Background</title> <p>The logEuroSCORE is an established tool to predict the risk of mortality during cardiac surgery. In high‐risk patients percutaneous mitral valve repair with the MitraClip system represents a less‐invasive alternative</p> </sec> <sec id="ccd25493-sec-0003" sec-type="section"> <title>Methods</title> <p>Data from 1002 patients, who underwent percutaneous mitral valve repair with the MitraClip system, were analyzed in the German Transcatheter Mitral Valve Interventions (TRAMI) Registry. A logEuroSCORE (mortality risk in %) ≥ 20 was considered high risk</p> </sec> <sec id="ccd25493-sec-0004" sec-type="section"> <title>Results</title> <p>Of all patients, 557 (55.6%) had a logEuroSCORE ≥ 20. Implantation of the MitraClip was successful in 95.5 % (942/986) patients. Moderate residual mitral valve regurgitation was more often detected in patients with a logEuroSCORE ≥ 20 (23.8% vs. 17.1%, respectively, <italic>P</italic> < 0.05). In patients with a logEuroSCORE ≥ 20 the procedural complication rate was 8.9% (vs. 6.4, n.s.) and the in‐hospital MACCE rate 4.9% (vs. 1.4% <italic>P</italic> < 0.01). The in‐hospital mortality rate in patients with a logEuroSCORE ≥ 20 and logEuroSCORE < 20 was 4.3 and 1.1%, respectively (<italic>P</italic> ≤ 0.01)</p> </sec> <sec id="ccd25493-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Percutaneous mitral valve repair with the MitraClip system is feasible in patients with a logEuroSCORE ≥ 20 with similar procedural results compared to patients with lower predicted risk. Although mortality was four times higher than in patients with logEuroSCORE < 20, mortality in high risk patients was lower than predicted. In those with a logEuroSCORE ≥ 20, moderate residual mitral valve regurgitation was more frequent. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>