1-Year Outcomes of Transcatheter Mitral Valve Replacement in Patients With Severe Mitral Annular Calcification

1-Year Outcomes of Transcatheter Mitral Valve Replacement in Patients With Severe Mitral Annular Calcification

Author Guerrero, Mayra Google Scholar
Urena, Marina Google Scholar
Himbert, Dominique Google Scholar
Wang, Dee Dee Google Scholar
Eleid, Mackram Google Scholar
Kodali, Susheel Google Scholar
George, Isaac Google Scholar
Chakravarty, Tarun Google Scholar
Mathur, Moses Google Scholar
Holzhey, David Google Scholar
Pershad, Ashish Google Scholar
Fang, H. Kenith Google Scholar
O'Hair, Daniel Google Scholar
Jones, Noah Google Scholar
Mahadevan, Vaikom S. Google Scholar
Dumonteil, Nicolas Google Scholar
Rodes-Cabau, Josep Google Scholar
Piazza, Nicolo Google Scholar
Ferrari, Enrico Google Scholar
Ciaburri, Daniel Google Scholar
Nejjari, Mohammed Google Scholar
DeLago, Augustin Google Scholar
Sorajja, Paul Google Scholar
Zahr, Firas Google Scholar
Rajagopal, Vivek Google Scholar
Whisenant, Brian Google Scholar
Shah, Pinak Bipin Google Scholar
Sinning, Jan-Malte Google Scholar
Witkowski, Adam Google Scholar
Eltchaninoff, Helene Google Scholar
Dvir, Danny Google Scholar
Martin, Bena Google Scholar
Attizzani, Guilherme F. Google Scholar
Gaia, Diego Felipe Autor UNIFESP Google Scholar
Nunes, Nagela S. V. Google Scholar
Fassa, Amir-Ali Google Scholar
Kerendi, Faraz Google Scholar
Pavlides, Gregory Google Scholar
Iyer, Vijay Google Scholar
Kaddissi, Georges Google Scholar
Witzke, Christian Google Scholar
Wudel, James Google Scholar
Mishkel, Gregory Google Scholar
Raybuck, Bryan Google Scholar
Wang, Chi Google Scholar
Waksman, Ron Google Scholar
Palacios, Igor Google Scholar
Cribier, Alain Google Scholar
Webb, John Google Scholar
Bapat, Vinnie Google Scholar
Reisman, Mark Google Scholar
Makkar, Raj Google Scholar
Leon, Martin Google Scholar
Rihal, Charanjit Google Scholar
Vahanian, Alec Google Scholar
O'Neill, William Google Scholar
Feldman, Ted Google Scholar
Abstract BACKGROUND The risk of surgical mitral valve replacement in patients with severe mitral annular calcification (MAC) is high. Several patients worldwide with severe MAC have been treated successfully with transcatheter mitral valve replacement (TMVR) using balloon-expandable aortic transcatheter valves. The TMVR in MAC Global Registry is a multicenter registry that collects data on outcomes of these procedures. OBJECTIVES The goal of this study was to evaluate 1-year outcomes in this registry. METHODS This study was a multicenter retrospective review of clinical outcomes. RESULTS A total of 116 extreme surgical risk patients with severe MAC underwent TMVR

106 had a procedure date > 1 year before data-lock and were included in the analysis. Their mean age was 73 +/- 12 years, and 68% were female. The mean Society of Thoracic Surgeons score was 15.3 +/- 11.6%, and 90% were in New York Heart Association functional class III or IV. Thirty-day and 1-year all-cause mortality was 25% and 53.7%, respectively. Most patients who survived 30 days were alive at 1 year (49 of 77 [63.6%]), and the majority (71.8%) were in New York Heart Association functional class I or II. Echocardiography data at 1 year were available in 34 patients. Mean left ventricular ejection fraction was 58.6 +/- 11.2%, mean mitral valve area was 1.9 +/- 0.5 cm(2), mean mitral gradient was 5.8 +/- 2.2 mm Hg, and 75% had zero or trace mitral regurgitation. CONCLUSIONS TMVR with balloon-expandable aortic valves in extreme surgical risk patients with severe MAC is feasible but associated with high 30-day and 1-year mortality. Most patients who survive the 30-day post-procedural period are alive at 1 year and have sustained improvement of symptoms and transcatheter valve performance. The role of TMVR in patients with MAC requires further evaluation in clinical trials. (C) 2018 by the American College of Cardiology Foundation.
Keywords calcific mitral valve stenosis
mitral annular calcification
mitral valve disease
mitral valve replacement
transcatheter valve replacement
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Sponsor Edwards Lifesciences
Medtronic
Boston Scientific
Abbott Vascular
Valtech
Date 2018
Published in Journal Of The American College Of Cardiology. New York, v. 71, n. 17, p. 1841-1853, 2018.
ISSN 0735-1097 (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent 1841-1853
Origin http://dx.doi.org/10.1016/j.jacc.2018.02.054
Access rights Closed access
Type Article
Web of Science ID WOS:000430670000001
URI https://repositorio.unifesp.br/handle/11600/55578

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