Transcatheter edge-to-edge repair in severe mitral regurgitation following acute myocardial infarction - aetiology-based analysis

被引：3

作者：

Haberman, Dan ^{[1
,2
]}

Estevez-Loureiro, Rodrigo ^{[3
]}

Czarnecki, Andrew ^{[4
]}

Melillo, Francesco ^{[5
]}

Adamo, Marianna ^{[6
]}

Villablanca, Pedro ^{[7
]}

Sudarsky, Doron ^{[8
]}

Praz, Fabien ^{[9
]}

Perl, Leor ^{[10
,11
]}

Freixa, Xavier ^{[12
]}

Scotti, Andrea ^{[13
]}

Fefer, Paul ^{[14
,15
]}

Spargias, Konstantinos ^{[16
]}

Fam, Neil ^{[17
]}

Manevich, Lisa ^{[18
,19
]}

Masiero, Giulia ^{[20
]}

Nombela-Franco, Luis ^{[21
]}

Pascual, Isaac ^{[22
]}

Crimi, Gabriele ^{[23
]}

Ninios, Vlasis ^{[24
]}

Beeri, Ronen ^{[25
]}

Benito-Gonzalez, Tomas ^{[26
]}

Arzamendi, Dabit ^{[27
]}

Fernandez-Peregrina, Estefania ^{[27
]}

Giannini, Francesco ^{[28
]}

Mangieri, Antonio ^{[29
]}

Poles, Lion ^{[1
,2
]}

George, Jacob ^{[1
,2
]}

Echarte Morales, Julio Cesar ^{[3
]}

Caneiro-Queija, Berenice ^{[3
]}

Denti, Paolo ^{[5
]}

Schiavi, Davide ^{[5
]}

Latib, Azeem ^{[13
]}

Chrissoheris, Michael ^{[16
]}

Danenberg, Haim ^{[17
]}

Tarantini, Giuseppe ^{[20
]}

Dvir, Danny ^{[30
]}

Maisano, Francesco ^{[31
]}

Taramasso, Maurizio ^{[32
]}

Shuvy, Mony ^{[30
]}

机构：

[1] Kaplan Med Ctr, Heart Ctr, IL-7661041 Rehovot, Israel

[2] Hebrew Univ Jerusalem, Jerusalem, Israel

[3] Hosp Alvaro Cunqueiro, Div Intervent Cardiol, Vigo, Spain

[4] Univ Toronto, Sunnybrook Hlth Sci Ctr, Schulich Heart Ctr, Toronto, ON, Canada

[5] Univ Vita Salute San Raffaele, IRCCS San Raffaele Sci Inst, Dept Ophthalmol, Milan, Italy

[6] Univ Brescia, Inst Cardiol, Dept Med & Surg Specialties, ASST Spedali Civili,Radiol Sci & Publ Hlth, Brescia, Italy

[7] Henry Ford Hosp, Ctr Struct Heart Dis, Detroit, MI USA

[8] Baruch Padeh Med Ctr, Cardiovasc Inst, Poria, Israel

[9] Univ Bern, Bern Univ Hosp, Inselspital, Bern, Switzerland

[10] Tel Aviv Univ, Rabin Med Ctr, Cardiol Dept, Tel Aviv, Israel

[11] Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel

[12] Hosp Clin Barcelona, Intervent Cardiol Unit, Barcelona, Spain

[13] Montefiore Med Ctr, Albert Einstein Coll Med, Montefiore Einstein Ctr Heart & Vasc Care, Bronx, NY USA

[14] Tel Aviv Univ, Leviev Heart Ctr, Sheba Med Ctr, Tel Aviv, Israel

[15] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel

[16] HYGEIA Hosp, Dept Transcatheter Heart Valves, Athens, Greece

[17] Univ Toronto, St Michaels Hosp, Div Cardiol, Toronto, ON, Canada

[18] E Wolfson Med Ctr, Dept Cardiol, Holon, Israel

[19] Tel Aviv Univ, Tel Aviv, Israel

[20] Univ Padua, Dept Cardiac Thorac Vasc Sci & Publ Hlth, Padua, Italy

[21] IdISSC, Hosp Clin San Carlos, Inst Invest Sanitaria San Carlos, Madrid, Spain

[22] Hosp Univ Cent Asturias, Dept Cardiol, Oviedo, Spain

[23] Policlin San Matteo, Cardiac Catheterizat Lab, Pavia, Italy

[24] Interbalkan European Med Ctr, Dept Cardiol, Thessaloniki, Greece

[25] Hadassah Hebrew Univ, Med Ctr, Heart Inst, Jerusalem, Israel

[26] Univ Hosp Leon, Intervent Cardiol Unit, Leon, Spain

[27] Hosp St Creu & Santa Pau, Intervent Cardiol Unit, Barcelona, Spain

[28] IRCCS Osped Galeazzi St Ambrogio, Div Cardiol, Milan, Italy

[29] IRCCS Humanitas Res Hosp, Cardio Ctr, Milan, Italy

[30] Hebrew Univ Jerusalem, Jesselson Integrated Heart Ctr, Shaare Zedek Med Ctr, Jerusalem, Israel

[31] Univ Vita Salute San Raffaele, Sch Med, Milan, Italy

[32] HerzZentrum Hirslanden Zurich, Clin Cardiac Surg, Zurich, Switzerland

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2025年 / 27卷 / 05期

关键词：

Cardiogenic shock; Mitral regurgitation; Myocardial infarction; Papillary muscle rupture; Transcatheter edge-to-edge repair; MECHANICAL COMPLICATIONS; AMERICAN SOCIETY; VALVE REPAIR; ECHOCARDIOGRAPHY; RECOMMENDATIONS; OUTCOMES;

D O I：

10.1002/ejhf.3582

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims To evaluate the association between transcatheter edge-to-edge repair (TEER) and outcomes in patients with significant mitral regurgitation (MR) following acute myocardial infarction (MI), focusing on the aetiology of acute post-MI MR in high-risk surgical patients. Methods and results The International Registry of MitraClip in Acute Mitral Regurgitation following Acute Myocardial Infarction (IREMMI) includes 187 patients with severe MR post-MI managed with TEER. Of these, 176 were included in the analysis, 23 (13%) patients had acute papillary muscle rupture (PMR) and 153 (87%) acute secondary MR. The mean age was 70 +/- 10 years and 41% were female. PMR patients had fewer cardiovascular risk factors: hypertension (52% vs. 73%, p = 0.04), diabetes (26% vs. 48%, p < 0.01) but a higher left ventricular ejection fraction (45 +/- 15% vs.35 +/- 10%, p < 0.01) compared secondary MR patients. PMR patients were more likely to present in cardiogenic shock (91% vs. 51%, p = 0.001), require mechanical circulatory support (74% vs. 34%, p = 0.01), and had a higher EuroSCORE II (23 +/- 13% vs. 13 +/- 11%, p = 0.011). The median time from MI to TEER was shorter in PMR (6 days) versus secondary MR (20 days) (p < 0.01). Procedural success was similar (87% vs. 92%, p = 0.49) with comparable MR grade reduction. However, PMR patients had significantly higher in-hospital mortality rates (adjusted odds ratio [OR] 3.05, 95% confidence interval [CI] 1.15-8.12, p = 0.02), 30-day mortality rates (unadjusted OR 3.99, 95% CI 1.42-11.26, p = 0.01) and a higher rate of conversion to surgical mitral valve replacement (22% vs. 3%, p < 0.01) (unadjusted OR 8.17, 95% CI 2.15-30.96, p < 0.001). Aetiology of MR, cardiogenic shock, and procedure timing significantly impacted in-hospital mortality. After adjusting for EuroSCORE II and cardiogenic shock, MR aetiology remained the strongest predictor (adjusted OR 6.71; 95% CI 2.06-21.86, p < 0.01). Conclusion Transcatheter edge-to-edge repair may be considered a salvage or bridge procedure in decompensated post-MI MR patients of both aetiologies; however, patients with PMR have a higher risk of mortality and conversion to surgery.

引用

页码：912 / 921

页数：10

共 31 条

[31] Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance [J].

Zoghbi, William A. ;

Adams, David ;

Bonow, Robert O. ;

Enriquez-Sarano, Maurice ;

Foster, Elyse ;

Grayburn, Paul A. ;

Hahn, Rebecca T. ;

Han, Yuchi ;

Hung, Judy ;

Lang, Roberto M. ;

Little, Stephen H. ;

Shah, Dipan J. ;

Shernan, Stanton ;

Thavendiranathan, Paaladinesh ;

Thomas, James D. ;

Weissman, Neil J. .

JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2017, 30 (04) :303-371

← 1 2 3 4 →