Reparación endovascular de la insuficiencia mitral Dr. Samir Kapadia
Insuficiencia mitral: indicaciones de intervención
Marcelo Llancaqueo 2011-08-04
MitraScore: What Does the Final Result of Edge-to-Edge Treatment of Mitral Regurgitation Provide?
Edge-to-edge treatment has proven to be a safe and effective technique in follow-up, decreasing mortality and hospitalizations for heart failure when a good result is achieved. The MitraScore was developed to assess the outcome at the end of the procedure. In that sense, results <3 represent mild mitral regurgitation, which would be related to lower...
ACC 2023 | COAPT Study: 5 Year Followup after Transcatheter Repair of Secondary Mitral Regurgitation
The five year outcomes of the multicenter open label COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) were presented at ACC 2023; it included 614 patients with cardiac failure (CF) and moderate to severe (3+/4+) symptomatic secondary mitral regurgitation, despite medical therapy. Patients were randomized 1:1...
Secondary Mitral Regurgitation: Stages of Heart Failure and Prognostic Implications after Transcatheter Edge-to-Edge Repair
We are already familiar with the strong impact of secondary mitral valve regurgitation (SMR) in survival and quality of life. Most of these patients present heart failure (HF) with reduced ejection fraction (HFrEF). Stages of heart failure based on extra-mitral cardiac involvement has been shown relevant. There is also extensive research on aortic valve disease...
Edge-to-Edge Repair Reduces Hospitalization and Mortality Rates in Secondary Mitral Valve Regurgitation?
Severe secondary mitral valve regurgitation is associated to hospitalization and mortality. The COAPT study has shown the superiority of guideline directed medical therapy at maximal tolerated doses according to guidelines (GDMT) plus edge-to-edge transcatheter repair (TEER) versus GMDT alone. However, at present there is no information on the impact of hospitalizations and their relationship to...
Post-MitraClip Mitral Valve Stenosis: Bad Prognosis
The EVEREST II trial has shown the MitraClip has similar mortality rate to that of surgery and, on the other hand, we are well aware that residual mitral regurgitation (MR) is associated with a strong negative impact. However, research has shown little about transvalvular gradient after MitraClip and what it entails. 268 patients receiving MitraClip were...
Improvements in COAPT Trial for Functional Mitral Regurgitation
Patients with heart failure and moderate-to-severe secondary mitral regurgitation may benefit from transcatheter mitral valve repair. There are benefits at 3 years, even in hard points such as mortality rate. The COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial showed fewer heart failure hospitalizations and...
New Valvular Heart Disease Guidelines with Key TAVI and Mitral Regurgitation Updates
Valvular heart disease management guidelines were updated last week by the AHA and the ACC. The last complete version had been published in 2014; therefore many of its recommendations have become obsolete before the latest evidence. The studies that made the FDA approve TAVI for low-risk patients are probably the most important incorporations. They also...
Percutaneous Annuloplasty in Functional Mitral Regurgitation vs. Sham Procedure
In cases where it is difficult to demonstrate the improvement of a drug or a device in hard endpoints such as mortality, we should look for softer and easier to prove endpoints. The problem is that these soft endpoints are often subjective (such as sensation of shortness of breath or angina pectoris) and they could...