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Pulmonary Venous Waveforms Predict Rehospitalization and Mortality After Percutaneous Mitral Valve Repair.

Publication ,  Journal Article
Corrigan, FE; Chen, JH; Maini, A; Lisko, JC; Alvarez, L; Kamioka, N; Reginauld, S; Gleason, PT; Condado, JF; Wei, JW; Binongo, JN; Keegan, P ...
Published in: JACC Cardiovasc Imaging
October 2019

OBJECTIVES: In this study, the authors hypothesized that intraprocedural improvement of pulmonary venous (PV) waveforms are predictive of improved outcomes. In this report, they analyzed intraprocedural invasive and echocardiographic changes with respect to rehospitalization and mortality. BACKGROUND: The effects of hemodynamic changes during percutaneous mitral valve repair (PMVR) with MitraClip (Abbott Vascular, Santa Clara, California) are incompletely characterized. METHODS: The authors retrospectively reviewed records and intraprocedural transesophageal echocardiograms of 115 consecutive patients (age 76 ± 12 years) who underwent PMVR for mitral regurgitation (MR) from May 2013 to January 2017 at Emory University Hospital. They assessed intraprocedural PV waveforms for improvement in morphology, measured change in MR grade by semiquantitative methods, evaluated invasive changes in left atrial pressure (LAP) and V-wave, and compared with 30-day and 1-year rehospitalization and all-cause mortality. RESULTS: Ninety-three cases (80%) had PV waveforms before and after clip placement sufficient for analysis, of which 67 (73%) demonstrated intraprocedural improvement in PV morphology and 25 (27%) did not. At 24 months, 57 (85%) of those with PV improvement were living, compared with only 10 (40%) of those without improvement. Proportional hazards models demonstrated a significant survival advantage in those with PV improvement (hazard ratio [HR]: 0.28, 95% confidence interval [CI]: 0.08 to 0.93, p = 0.038). By multivariable analysis, PV improvement predicted reduced 1-year cardiac rehospitalization (odds ratio [OR]: 0.18, p = 0.044). Intraprocedural assessment of MR grade and invasive hemodynamics did not consistently predict mortality and rehospitalization. CONCLUSIONS: PV waveforms are important markers of procedural success after PMVR. Our data show intraprocedural PV waveforms may predict rehospitalization and mortality after PMVR. A larger, multicenter cohort will be important to clarify this relationship.

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Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

October 2019

Volume

12

Issue

10

Start / End Page

1905 / 1913

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Pulmonary Veins
  • Pulmonary Circulation
  • Predictive Value of Tests
  • Patient Readmission
  • Mitral Valve Insufficiency
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Corrigan, F. E., Chen, J. H., Maini, A., Lisko, J. C., Alvarez, L., Kamioka, N., … Lerakis, S. (2019). Pulmonary Venous Waveforms Predict Rehospitalization and Mortality After Percutaneous Mitral Valve Repair. JACC Cardiovasc Imaging, 12(10), 1905–1913. https://doi.org/10.1016/j.jcmg.2018.07.014
Corrigan, Frank E., John H. Chen, Aneel Maini, John C. Lisko, Lucia Alvarez, Norihiko Kamioka, Shawn Reginauld, et al. “Pulmonary Venous Waveforms Predict Rehospitalization and Mortality After Percutaneous Mitral Valve Repair.JACC Cardiovasc Imaging 12, no. 10 (October 2019): 1905–13. https://doi.org/10.1016/j.jcmg.2018.07.014.
Corrigan FE, Chen JH, Maini A, Lisko JC, Alvarez L, Kamioka N, et al. Pulmonary Venous Waveforms Predict Rehospitalization and Mortality After Percutaneous Mitral Valve Repair. JACC Cardiovasc Imaging. 2019 Oct;12(10):1905–13.
Corrigan, Frank E., et al. “Pulmonary Venous Waveforms Predict Rehospitalization and Mortality After Percutaneous Mitral Valve Repair.JACC Cardiovasc Imaging, vol. 12, no. 10, Oct. 2019, pp. 1905–13. Pubmed, doi:10.1016/j.jcmg.2018.07.014.
Corrigan FE, Chen JH, Maini A, Lisko JC, Alvarez L, Kamioka N, Reginauld S, Gleason PT, Condado JF, Wei JW, Binongo JN, Keegan P, Howell S, Thourani VH, Block PC, Clements SD, Babaliaros VC, Lerakis S. Pulmonary Venous Waveforms Predict Rehospitalization and Mortality After Percutaneous Mitral Valve Repair. JACC Cardiovasc Imaging. 2019 Oct;12(10):1905–1913.
Journal cover image

Published In

JACC Cardiovasc Imaging

DOI

EISSN

1876-7591

Publication Date

October 2019

Volume

12

Issue

10

Start / End Page

1905 / 1913

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Pulmonary Veins
  • Pulmonary Circulation
  • Predictive Value of Tests
  • Patient Readmission
  • Mitral Valve Insufficiency