학술논문
Transcatheter mitral valve repair with MitraClip: comparison of NT, NTr, and XTr Devices.
Document Type
Academic Journal
Author
Corcione N; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.; Ferraro P; Unità Operativa di Emodinamica, Santa Lucia Hospital, San Giuseppe Vesuviano, Italy.; Finizio F; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.; Cimmino M; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.; Albanese M; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.; Biondi-Zoccai G; Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Cardiology Unit, Santa Maria Goretti Hospital, Latina, Italy. Email: giuseppe.biondizoccai@uniroma1.it.; Denti P; Department of Cardiac Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Rubbio AP; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.; Bartorelli AL; Centro Cardiologico Monzino, IRCCS, Milan, Italy, and Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.; Mongiardo A; Division of Cardiology, Department of Medical and Surgical Sciences, 'Magna Graecia' University.; Giordano S; Division of Cardiology, Department of Medical and Surgical Sciences, 'Magna Graecia' University.; De Felice F; Division of Interventional Cardiology, Azienda Ospedaliera S. Camillo Forlanini, Rome, Italy.; Adamo M; Cardiac Catheterization Laboratory and Cardiology, ASST Spedali Civili di Brescia, and Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia, both in Brescia, Italy.; Montorfano M; Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.; Baldi C; Heart Department, University Hospital 'Scuola Medica Salernitana', Salerno, Italy.; Tarantini G; Department of Cardiac, Thoracic and Vascular Science, Interventional Cardiology Unit, University of Padua, Padua, Italy.; Giannini F; Division of Cardiology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.; Ronco F; Interventional Cardiology, Department of Cardio-Thoracic and Vascular Sciences, Ospedale dell'Angelo, AULSS3 Serenissima, Mestre, Venezia, Italy.; Monteforte I; Divisione di Cardiologia, A.O. dei Colli, Ospedale Monaldi, Napoli.; Villa E; Cardiac Surgery Unit and Valve Center, Poliambulanza Foundation Hospital, Brescia, Italy.; Ferrario M; Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.; Fiocca L; Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.; Castriota F; Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy.; Squeri A; Interventional Cardiology Unit, GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy.; Tamburino C; Division of Cardiology, Centro Alte Specialità e Trapianti (CAST), Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy.; Bedogni F; Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.; Giordano A; Unità Operativa di Interventistica Cardiovascolare, Pineta Grande Hospital, Castel Volturno, Italy.
Source
Publisher: HMP Communications Country of Publication: United States NLM ID: 8917477 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-2501 (Electronic) Linking ISSN: 10423931 NLM ISO Abbreviation: J Invasive Cardiol Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: Transcatheter edge-to-edge repair (TEER) has become an established minimally invasive treatment for significant mitral regurgitation. Ongoing refinements and the availability of different clipping devices have expanded the indications for and effectiveness of TEER, but comprehensive comparative data on this issue are lacking. In this study, we compared NT, NTr, and XTr MitraClip devices (Abbot) for TEER.
Methods: Details on patient, imaging, and procedural details, as well as short- and long-term outcomes, were sought from a national prospective clinical registry on TEER with MitraClip. The primary outcome of interest was discharge after procedural success without major clinical complications.
Results: A total of 2236 patients were included, 1228 (54.9%) in whom NT implantation only was attempted, 233 (10.4%) in whom NTr but not XTr implantation was attempted, and 775 (34.7%) in whom XTr implantation was attempted. Clinical and imaging features differed substantially across the groups, reflecting expanding indications with NTr and XTr devices. In-hospital outcomes were largely similar among the 3 groups, including death. Long-term unadjusted estimates of effect showed significant differences in several outcomes, including death, rehospitalization, and their composite, which demonstrated that NT was associated with more unfavorable outcomes compared with the other devices (all P less than .05). However, most differences depended on baseline features, as adjusted analysis showed no significant differences for early as well as long-term outcomes, including long-term death, rehospitalization, and their composite (all P greater than .05).
Conclusions: New-generation MitraClip devices are associated with favorable procedural and clinical outcomes, despite being used in patients with more adverse features, when compared with patients treated with previous devices.
Methods: Details on patient, imaging, and procedural details, as well as short- and long-term outcomes, were sought from a national prospective clinical registry on TEER with MitraClip. The primary outcome of interest was discharge after procedural success without major clinical complications.
Results: A total of 2236 patients were included, 1228 (54.9%) in whom NT implantation only was attempted, 233 (10.4%) in whom NTr but not XTr implantation was attempted, and 775 (34.7%) in whom XTr implantation was attempted. Clinical and imaging features differed substantially across the groups, reflecting expanding indications with NTr and XTr devices. In-hospital outcomes were largely similar among the 3 groups, including death. Long-term unadjusted estimates of effect showed significant differences in several outcomes, including death, rehospitalization, and their composite, which demonstrated that NT was associated with more unfavorable outcomes compared with the other devices (all P less than .05). However, most differences depended on baseline features, as adjusted analysis showed no significant differences for early as well as long-term outcomes, including long-term death, rehospitalization, and their composite (all P greater than .05).
Conclusions: New-generation MitraClip devices are associated with favorable procedural and clinical outcomes, despite being used in patients with more adverse features, when compared with patients treated with previous devices.