Comparison of clinical and echocardiographic outcomes and quality of life in patients with severe mitral regurgitation treated by MitraClip implantation or treated conservatively

The most common alternative method of treatment for patients with severe mitral regurgitation (MR) is the implantation of a MitraClip device. To evaluate clinical and echocardiographic outcomes and quality of life (QoL) in patients with severe secondary MR, disqualified from surgical intervention, t...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Postępy w kardiologii interwencyjnej 2018-01, Vol.14 (3), p.291-298
Hauptverfasser: Krawczyk-Ożóg, Agata, Siudak, Zbigniew, Sorysz, Danuta, Hołda, Mateusz K, Płotek, Anna, Dziewierz, Artur, Gackowski, Andrzej, Dudek, Dariusz
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:The most common alternative method of treatment for patients with severe mitral regurgitation (MR) is the implantation of a MitraClip device. To evaluate clinical and echocardiographic outcomes and quality of life (QoL) in patients with severe secondary MR, disqualified from surgical intervention, treated by implantation of a MitraClip in comparison to conservative therapy. A total of 33 patients were included. Patients were stratified by treatment method: group A, MitraClip implantation ( = 10); group B, conservative treatment ( = 23). Clinical, echocardiographic, and QoL (EQ-5D-3L, SF-12v2 Health Survey) characteristics were compared at baseline and at follow-up of 8.0 ±2.3 months. In group A, 2 deaths were observed: one patient died 7 days after MitraClip implantation, and the second patient died 4 months after the procedure. No cases of rehospitalization were reported. In group B, 4 (17.4%) deaths and 6 (26.1%) hospitalizations were reported. After MitraClip implantation a significant reduction of the NYHA class ( = 0.02), decrease in grade of MR ( = 0.01), vena contracta width ( = 0.006), effective regurgitant orifice area (EROA) ( = 0.003), regurgitant volume ( = 0.03) and end-diastolic left ventricle diameter ( = 0.02) as well as an improvement in QoL were reported. There were no significant changes in the NYHA class and QoL in the group treated conservatively. In those patients, we observed increased intercommissural mitral annulus diameter ( = 0.03), left atrium diameter ( = 0.002), and right ventricle dimension ( = 0.008), more severe tricuspid regurgitation ( = 0.02) and lower mitral annular plane systolic excursion ( = 0.01). Patients with severe secondary MR treated with the MitraClip achieved a significant reduction in symptoms and MR grade, as well as an improvement in QoL, as compared to patients treated conservatively.
ISSN:1734-9338
1897-4295
DOI:10.5114/aic.2018.78334