With an approximate incidence of 0.05% to 0.25%, post-acute myocardial infarction (AMI) mitral valve failure caused by papillary muscle rupture is not exactly common. However, it is associated to high mortality rate, ranging between 36% and 80%. Current guidelines recommend surgical treatment, but more often than not surgery involves prohibitive or extremely high risk, with...
Mitral valve regurgitation (MR) is a common cause behind heart failure and is associated to hospitalization for heart failure and higher mortality. Transcatheter edge-to-edge repair (TEER), together with guideline-directed medical therapy (GDMT) has been shown beneficial in high risk patients, according to the COAPT study. However, there is a significant group of patients that make...
Transcatheter edge-to-edge mitral valve repair with Mitraclip has become a valid strategy to treat mitral valve regurgitation (MR) when surgery is not viable. However, after discharge, residual MR (>moderate) can affect over 10% of patients, because of the use of anesthesia, which alters pre and post procedural measurements. In this context, eco-stress could become a...
The natural history of tricuspid regurgitation is associated to hospitalization for cardiac failure and mortality. This is why the AHA/ACC guidelines recommend surgery when the tricuspid fails during left valve surgical repair, because its slow progression is associated with high mortality (35%). Many of these patients are high risk and percutaneous intervention has surged as...
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...
Severe tricuspid regurgitation (TR) is difficult to manage and is associated to high morbimortality. Surgical repair is complex and not free from complications: its mortality rate ranges from 5 to 20% and depends on series, surgeon and center expertise. Edge-to-edge repair with clips has become a valid alternative to treat this disease, but most data...
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...
At present, an important group of patients with mitral valve disease are at high surgical risk, especially those with deteriorated bio-prosthesis, severe mitral annulus calcification or those who had received mitral annuloplasty. Percutaneous treatment with balloon expandable valves is a valid option to treat these patients, seeing as their 30 day and one-year outcomes look...
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...
Approximately 1 in 5 patients admitted for cardiogenic shock (CS) were observed to have moderate to severe mitral insufficiency (MI), which increases the risk of mortality by about 60%. To date, there is limited data on the role of transcatheter edge-to-edge repair therapy in this setting. The aim of this study was to describe the...