Continuous Monitoring of Left Atrial Pressure during MitraClip, Regardless Echocardiography

The aim of this study was to assess the use of measuring left atrial pressure to complement transesophageal echocardiography and doppler imaging.

MitraClip: ¿debemos intervenir antes a nuestros pacientes?Procedure efficacy is measured in the cath lab by echocardiography. However, these measurements are operator dependent and might be influenced by left ventricular function and changes in left atrial compliance.

 

The study looked at continuous left sided pressure in 50 patients undergoing MitraClip. These measurements included left atrial V-wave pressure, and left atrial mean, systolic, and end-diastolic pressures. Left atrial pressures were indexed to left ventricular pressures to compensate for variations in afterload during procedure.


Read also: TCT 2018 | TriValve: Mitraclip for the Tricuspid Valve.


70% of patients had degenerative mitral regurgitation. Mitral regurgitation grade by echocardiography decreased from 3+ to 0+, and atrial V-wave (p<0.001), mean left atrial pressure (p=0.007), end diastolic pressure (p=0.001) and all left atrial pressures indexed values also decreased after MitraClip.

 

Intra-procedural increase of mean left atrial pressure was associated to a smaller number of rehospitalizations for cardiac failure and more chances to reach functional class III or IV at follow-up. These events could not be predicted by post procedure 2+ mitral regurgitation.

 

Conclusions

This study shows the value of continued real-time monitoring of left atrial pressure to predict events after treating mitral regurgitation with MitraClip. An increase in left atrial mean pressure is a predictor of worse prognosis at short term, regardless echocardiographic findings.

 

Original title: Continuous Direct Left Atrial Pressure. Intraprocedural Measurement Predicts Clinical Response Following MitraClip Therapy.

Reference: Shingo Kuwata et al. J Am Coll Cardiol Intv 2019, article in press.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

ACC 2025 | TAVI in Low-Risk Patients: 5-Year Outcomes of EVOLUTE LOW RISK

Transcatheter aortic valve implantation (TAVI) is a valid alternative to surgery in low-risk patients with severe aortic stenosis. However, one of its main limitations...

ACC 2025 | BHF PROTECT-TAVI: Are Cerebral Protection Systems Necessary in TAVI?

TAVI has seen a steady increase in use, though stroke continues to be one of its unwanted complications, mostly ischemic and, less frequently, hemorrhagic. The...

ACC-2025 Congress Second Day Key Studies

BHF PROTECT-TAVI (Kharbanda RK, Kennedy J, Dodd M, et al.)The largest randomized  trial carried out across 33 UK centers between 2020 and 2024, assessing...

Prospective Analysis of the Feasibility of the PASCAL System for Transcatheter Mitral Repair: OneForAll Registry

Courtesy of Dr. Juan Manuel Pérez. Mitral transcatheter edge-to-edge repair (M-TEER) is an effective option for patients with severe mitral regurgitation who are at high...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Patients at High Risk of Bleeding After Coronary Angioplasty: Are Risk Assessment Tools ARC-HBR and PRECISE-DAPT Useful?

Patients undergoing coronary stenting typically receive dual antiplatelet therapy (DAPT) for 6 to 12 months, consisting of a P2Y12 receptor inhibitor and aspirin. While DAPT...

ACC 2025 | WARRIOR: Ischemia in Women with Non-Obstructive Coronary Artery Disease

Approximately half of all women with symptomatic ischemia who undergo coronary angiography are found to have non-obstructive coronary artery disease ((ischemia and non-obstructive coronary...

ACC 2025 | TAVI in Low-Risk Patients: 5-Year Outcomes of EVOLUTE LOW RISK

Transcatheter aortic valve implantation (TAVI) is a valid alternative to surgery in low-risk patients with severe aortic stenosis. However, one of its main limitations...