Dietl, Alexander and Prieschenk, Christine and Eckert, Franziska and Birner, Christoph and Luchner, Andreas and Maier, Lars S. and Buchner, Stefan (2018) 3D vena contracta area after MitraClip (c) procedure: precise quantification of residual mitral regurgitation and identification of prognostic information. CARDIOVASCULAR ULTRASOUND, 16: 1. ISSN 1476-7120,
Full text not available from this repository. (Request a copy)Abstract
Background: Percutaneous mitral valve repair (PMVR) is increasingly performed in patients with severe mitral regurgitation (MR). Post-procedural MR grading is challenging and an unsettled issue. We hypothesised that the direct planimetry of vena contracta area (VCA) by 3D-transoesophageal echocardiography allows quantifying post-procedural MR and implies further prognostic relevance missed by the usual ordinal scale (grade I-IV). Methods: Based on a single-centre PMVR registry containing 102 patients, the association of VCA reduction and patients' functional capacity measured as six-minute walk distance (6 MW) was evaluated. 3D-colour-Doppler datasets were available before, during and 4 weeks after PMVR. Results: Twenty nine patients (age 77.0 +/- 5.8 years) with advanced heart failure (75.9% NYHA III/IV) and severe degenerative (34%) or functional (66%) MR were eligible. VCA was reduced in all patients by PMVR (0.99 +/- 0.46 cm(2) vs. 0.22 +/- 0.15 cm(2), p < 0.0001). It remained stable after median time of 33 days (p = 0.999). 6 MW improved after the procedure (257.5 +/- 82.5 m vs. 295.7 +/- 96.3 m, p < 0.01). Patients with a decrease in VCA less than the median VCA reduction showed a more distinct improvement in 6 MW than patients with better technical result (p < 0.05). This paradoxical finding was driven by inferior results in very large functional MR. Conclusions: VCA improves the evaluation of small residual MR. Its post-procedural values remain stable during a short-term follow-up and imply prognostic information for the patients' physical improvement. VCA might contribute to a more substantiated estimation of treatment success in the heterogeneous functional MR group.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ONE-YEAR OUTCOMES; TO-EDGE REPAIR; VALVE REPAIR; HEART-FAILURE; DOPPLER-ECHOCARDIOGRAPHY; EUROPEAN ASSOCIATION; MAGNETIC-RESONANCE; AMERICAN SOCIETY; RECOMMENDATIONS; SEVERITY; Percutaneous mitral valve repair; MitraClip; 3D echocardiography; Vena contracta area; Six-minute walk test; NT-proBNP; Prognosis; Functional mitral regurgitation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 19 Mar 2020 13:54 |
| Last Modified: | 19 Mar 2020 13:54 |
| URI: | https://pred.uni-regensburg.de/id/eprint/15210 |
Actions (login required)
 |
View Item |
