Acute effect of percutaneous MitraClip therapy in patients with haemodynamic decompensation.

Published

Journal Article

AIMS: To evaluate the haemodynamic effect of acute procedural success (APS) after MitraClip therapy in patients with haemodynamic decompensation. METHODS AND RESULTS: Of 107 patients, 79 achieved APS after MitraClip implantation. The increase in cardiac index (CI) was primarily detected in patients with a low baseline CI (2.0 ± 0.5 to 2.5 ± 5 L/min/m(2), P < 0.001). There was a decrease in left ventricular end-diastolic pressure (LVEDP) (20 ± 5 to 13 ± 5 mmHg, P = 0.002) and mean pulmonary capillary wedge pressure (PCWPm) (20 ± 4 to 16 ± 5 mmHg, P = 0.001) in patients with values >15 mmHg at baseline, and a decrease in mean pulmonary artery systolic (PAPm) (36 ± 4 to 29 ± 7 mmHg P = 0.003) in those with values >30 mmHg before the MitraClip procedure. Patients with decompensation compared with patients with compensation experienced significant reduction in LVEDP (-8.3 ± 11.9 mmHg vs. -0.2 ± 4.5 mmHg, P = 0.009), a reduction in PCWPm (-3.5 ± 5.6 mmHg vs. 1.9 ± 4.7 mmHg, P < 0.001), and a reduction in PAPm (-8 ± 9 mmHg vs. 3 ± 6 mmHg, P < 0.001). CONCLUSION: The favourable haemodynamic effects of MitraClip therapy on CI were primarily detected in patients with low CI before the procedure, and improvements in left-sided filling pressure and PAP were primarily seen in those with elevated values at baseline.

Full Text

Duke Authors

Cited Authors

  • Biner, S; Siegel, RJ; Feldman, T; Rafique, AM; Trento, A; Whitlow, P; Rogers, J; Moon, M; Lindman, B; Zajarias, A; Glower, D; Kar, S; EVEREST investigators,

Published Date

  • August 2012

Published In

Volume / Issue

  • 14 / 8

Start / End Page

  • 939 - 945

PubMed ID

  • 22588322

Pubmed Central ID

  • 22588322

Electronic International Standard Serial Number (EISSN)

  • 1879-0844

Digital Object Identifier (DOI)

  • 10.1093/eurjhf/hfs069

Language

  • eng

Conference Location

  • England