Acute effect of percutaneous MitraClip therapy in patients with haemodynamic decompensation

European Journal of Heart Failure
Simon BinerEVEREST Investigators

Abstract

To evaluate the haemodynamic effect of acute procedural success (APS) after MitraClip therapy in patients with haemodynamic decompensation. 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). 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 th...Continue Reading

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Citations

Sep 26, 2013·European Heart Journal Cardiovascular Imaging·Nina C Wunderlich, Robert J Siegel
May 7, 2013·Cardiovascular Ultrasound·Fabio GuarracinoAnna S Petronio
Mar 14, 2013·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Christian FrerkerKarl-Heinz Kuck
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