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Percutaneous vs surgical repair of mitral valve regurgitation: single institution early and midterm outcomes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Paranskaya, Liliya D'Ancona, Giuseppe Bozdag-Turan, Ilkay Akin, Ibrahim Kische, Stephan Turan, Gökmen R. Rehders, Tim Schneider, Henrik Westphal, Bernd Birkemeyer, Ralf Nienaber, Christoph A. Ince, Hüseyin
Description	Country affiliation: Germany Author Affiliation: Paranskaya L ( Heart Center, University Hospital, Rostock, Germany.)
Abstract	BACKGROUND: The objective of this study was to compare outcomes of surgical repair (SR) vs MitraClip (MC) implantation for severe mitral regurgitation (MR). METHODS: A retrospective analysis of patients treated within a single institution was performed. Patients had EuroSCORE [European System for Cardiac Operative Risk Evaluation] < 20%, left ventricular ejection fraction ≥45%, and grade 3+/4+ MR. RESULTS: Fifty patients (24 [48%] MC group, 26 [52%] SR group) with EuroSCORE 7.9 ± 5.6 were included. The MC group included 24 (48%) and the SR group 26 (52%) patients. Patients in the MC group had a significantly more complex comorbid profile (P < 0.001). Successful MC placement was in 22 patients (91.7%) and SR in 26 (100%). At discharge, no patient had grade 3+/4+ MR. There were no in hospital or 30-day deaths. At follow-up (mean 526 ± 398 days), further mitral valve surgery was necessary in 1 (3.8%) patient in the SR group and in 2 (8.3%) patients in the MC group (P = 0.26). One-year freedom from composite end point (death, stroke, myocardial infarction, major bleeding, cardiac rehospitalization) was 75.5% (SR 83% vs MC 67%; P = 0.18). Degree of residual MR Degree of residual MR immediately after the procedure was equally distributed in both groups (P = 0.13) and the sole independent determinant for composite outcome (odds ratio, 16.9; P = 0.024). CONCLUSIONS: MC in nonsurgical candidates and SR in surgical patients showed similar perioperative and follow-up outcomes at an institution experienced with both techniques. Neither MC nor SR were independently related to outcome whenever similar degrees of acute correction with minimal residual MR were achieved. However, these findings should be interpreted within the selection biases and the numerical limitations of the present study.
File Format	HTM / HTML
ISSN	0828282X
Issue Number	4
Volume Number	29
e-ISSN	19167075
Journal	Canadian Journal of Cardiology
Language	English
Publisher	Elsevier
Publisher Date	2013-04-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cardiology Heart Valve Prosthesis Implantation Methods Mitral Valve Insufficiency Surgery Aged Aged, 80 And Over Echocardiography Female Follow-up Studies Adverse Effects Humans Male Middle Aged Diagnosis Therapy Odds Ratio Retrospective Studies Severity Of Illness Index Stroke Volume Time Factors Treatment Outcome Comparative Study Journal Article
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine

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Percutaneous repair or surgery for mitral regurgitation. (Part 2)

Implementing Formal Mitral Heart Team Improves Multidisciplinary Evaluation Rate and Survival of Patients With Severe Primary Mitral Regurgitation.

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Percutaneous vs surgical repair of mitral valve regurgitation: single institution early and midterm outcomes.