1. Mortality Associated With Proportionality of Secondary Mitral Regurgitation After Transcatheter Mitral Valve Repair: North American Mitraclip for Functional Mitral Regurgitation Registry.
- Author
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Duggal NM, Engoren M, Chadderdon SM, Rodriguez E, Morse MA, Vannan MA, Yadav PK, Morcos M, Li F, Reisman M, Garcia-Sayan E, Raghunathan D, Sodhi N, Sorajja P, Chen L, Rogers JH, Calfon MA, Kovach CP, Gill EA, Zahr FE, Chetcuti SJ, Yuan Y, Mentz GB, Lim DS, and Ailawadi G
- Subjects
- Humans, Male, Female, Mitral Valve surgery, Treatment Outcome, Registries, North America, Mitral Valve Insufficiency epidemiology, Mitral Valve Insufficiency surgery, Heart Valve Prosthesis Implantation
- Abstract
The association, if any, between the effective regurgitant orifice area (EROA) to left ventricular end-diastolic volume (LVEDV) ratio and 1-year mortality is controversial in patients who undergo mitral transcatheter edge-to-edge repair (m-TEER) with the MitraClip system (Abbott Vascular, Santa Clara, CA). This study's objective was to determine the association between EROA/LVEDV and 1-year mortality in patients who undergo m-TEER with MitraClip. In patients with severe secondary (functional) mitral regurgitation (MR), we analyzed registry data from 11 centers using generalized linear models with the generalized estimating equations approach. We studied 525 patients with secondary MR who underwent m-TEER. Most patients were male (63%) and were New York Heart Association class III (61%) or IV (21%). Mitral regurgitation was caused by ischemic cardiomyopathy in 51% of patients. EROA/LVEDV values varied widely, with median = 0.19 mm
2 /ml, interquartile range [0.12,0.28] mm2 /ml, and 187 patients (36%) had values <0.15 mm2 /ml. Postprocedural mitral regurgitation severity was substantially alleviated, being 1+ or less in 74%, 2+ in 20%, 3+ in 4%, and 4+ in 2%; 1-year mortality was 22%. After adjustment for confounders, the logarithmic transformation (Ln) of EROA/LVEDV was associated with 1-year mortality (odds ratio 0.600, 95% confidence interval 0.386 to 0.933, p = 0.023). A higher Society of Thoracic Surgeons risk score was also associated with increased mortality. In conclusion, lower values of Ln(EROA/LVEDV) were associated with increased 1-year mortality in this multicenter registry. The slope of the association is steep at low values but gradually flattens as Ln(EROA/LVEDV) increases., Competing Interests: Declaration of competing interest Dr. Lim reports a relation with Abbott that includes funding grants; a relation with Boston Scientific Corp. that includes funding grants; a relation with Corvia Medical that includes funding grants; a relation with Edwards Lifesciences Corporation that includes funding grants; a relation with Medtronic Inc. that includes funding grants; a relation with Trisol that includes funding grants; a relation with Philips that includes consulting or advisory; a relation with Valgen that includes consulting or advisory; and a relation with Venus that includes consulting or advisory. Dr. Rodriguez reports a relation with Abbott that includes consulting or advisory, funding grants, and speaking and lecture fees. Dr. Zahr reports a relation with Medtronic Inc. that includes board membership, consulting or advisory, and funding grants; a relation with Edwards Lifesciences Corporation that includes funding grants; and a relation with SIEMENS that includes: funding grants. Dr. Ailawadi reports a relation with Medtronic Inc. that includes consulting or advisory; a relation with Abbott that includes consulting or advisory; a relation with Edwards Lifesciences Corporation that includes consulting or advisory; a relation with Gore that includes consulting or advisory; a relation with Anteris that includes consulting or advisory; a relation with AtriCure Inc. that includes consulting or advisory; a relation with CryoLife that includes consulting or advisory; a relation with Philips that includes consulting or advisory; and a relation with Johnson & Johnson that includes consulting or advisory. Dr. Rogers reports a relation with Abbott that includes consulting or advisory and funding grants; a relation with Boston Scientific Corp that includes consulting or advisory and funding grants; and a relation with Baylis Medical Company, Inc. that includes consulting or advisory. Dr. Chen reports a relation with Philips that includes consulting or advisory; a relation with Abbott that includes consulting or advisory; and a relation with Akura Medical that includes consulting or advisory. Dr. Vannan reports a relation with Abbott that includes funding grants and speaking and lecture fees. Dr. Duggal reports a relation with Medtronic Inc. that includes consulting or advisory. Dr. Sodhi reports a relation with Medtronic Inc that includes consulting or advisory; and a relation with Boston Scientific Corp that includes consulting or advisory. Dr. Sorajja reports a relation with 4C Medical Technologies Inc. that includes consulting or advisory; a relation with Anteris that includes consulting or advisory; a relation with Abbott that includes consulting or advisory; a relation with Boston Scientific Corp that includes consulting or advisory; a relation with Edwards Lifesciences Corporation that includes consulting or advisory; a relation with Evolution Medical that includes consulting or advisory; a relation with Foldax that includes consulting or advisory; a relation with GLG that includes consulting or advisory; a relation with Medtronic Inc. that includes consulting or advisory; a relation with Philips that includes consulting or advisory; a relation with SIEMENS that includes consulting or advisory; a relation with Shifamed that includes consulting or advisory; a relation with WL Gore that includes consulting or advisory; a relation with vDyne that includes consulting or advisory; and a relation with xDot that includes consulting or advisory. Dr. Yadav reports a relation with Edwards Lifesciences Corporation that includes consulting or advisory and speaking and lecture fees; a relation with Abbott that includes consulting or advisory and speaking and lecture fees; a relation with Boston Scientific Corp. that includes consulting or advisory and speaking and lecture fees; and a relation with Dasi Simulations that includes board membership. Dr. Chadderdon reports a relation with Medtronic Inc that includes consulting or advisory; a relation with Edwards Lifesciences Corporation that includes consulting or advisory; and a relation with GE Healthcare that includes funding grants. Dr. Chetcuti reports a relation with Medtronic Inc. that includes consulting or advisory and funding grants; a relation with Boston Scientific Corp. that includes consulting or advisory and funding grants; a relation with Jena that includes funding grants; a relation with Abbott that includes funding grants; a relation with Edwards Lifesciences Corporation that includes funding grants; and a relation with Gore that includes funding grants. The remaining authors have no competing interests to declare., (Copyright © 2023 Elsevier Inc. All rights reserved.)- Published
- 2024
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