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...
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...
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...
Courtesy of SBHCI. Prognosis of patients with cardiac failure who develop secondary mitral regurgitation due to dilation is uncertain. The COAPT study was carried out in 78 centers across the US and Canada and included patients with moderate to severe mitral regurgitation (3 or 4 crossovers) symptomatic despite optimal medical treatment (OMT). 614 patients were...
Courtesy of Dr. Carlos Fava. Edge to edge with MitraClip was shown effective and safe, and its outcomes have been improving over these past few years. However, one of its greatest challenges involves not being able to reduce mitral regurgitation (MR) after device implantation, resulting in the need for surgery, as some studies have shown...
PASCAL transcatheter valve repair system for mitral regurgitation has shown feasibility and safety to treat patients with grade 3+ or 4+, regardless etiology. Regurgitation grade was significantly reduced, and this was accompanied by clinical improvement in functional class, exercise capacity and quality of life. This study soon to be published in J Am Coll Cardiol...
Courtesy of Dr. Carlos Fava. The aetiology of mitral regurgitation (MR) may be divided into primary, organic or degenerative MR, and secondary or functional MR. These two present different physiopathology. The treatment strategy is different for each, and edge-to-edge treatment with Mitraclip is currently emerging as a valid alternative for high-risk patients. This study analyzed 943 patients...
The prognosis of patients with heart failure and mitral regurgitation secondary to ventricular dysfunction and dilation is guarded. Percutaneous mitral valve treatment of these patients may at least improve their symptoms. This study was conducted in 78 sites in the United States and Canada, and included patients with moderate-to-severe (3+) or severe (4+) mitral regurgitation who...
Prior studies such as the AMADEUS, TITAN or TITAN II have shown reduction of mitral valve regurgitation (MR) with the Carillon device. This sham-controlled randomized study tested the efficacy of this device in secondary mitral regurgitation. Primary end point was echocardiographic MR reduction (blind core lab) and secondary end point were hospitalization for cardiac failure,...
Courtesy of Dr. Adolfo Ferrero. INTRODUCCION: In patients with chronic heart failure and reduced left ventricular ejection fraction, severe secondary mitral valve regurgitation is associated with bad prognosis. Whether percutaneous mitral valve repair improves clinical results in this patient population, remains unclear, despite prior multicenter studies supporting this view. METHODS: Patients with severe secondary mitral...