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Impact of right ventricular function in transcatheter mitral valve repair procedures

Session Poster Session 3

Speaker Iria Silva Conde

Congress : Acute Cardiovascular Care 2019

  • Topic : interventional cardiology and cardiovascular surgery
  • Sub-topic : Interventional Cardiology - Other
  • Session type : Poster Session
  • FP Number : P828

Authors : A Alperi (Oviedo,ES), I Pascual Calleja (Oviedo,ES), V Leon Aguero (Oviedo,ES), R Padron Encalada (Oviedo,ES), AY Flores (Oviedo,ES), L Diaz-Chiron (Oviedo,ES), I Silva Conde (Oviedo,ES), P Florez Llano (Oviedo,ES), A Martinez Leon (Oviedo,ES), D Garcia Iglesias (Oviedo,ES), L Junquera Vega (Oviedo,ES), L Martinez Fernandez (Oviedo,ES), L Gutierrez De La Varga (Oviedo,ES), P Avanzas Fernandez (Oviedo,ES), C Moris De La Tassa (Oviedo,ES)


A Alperi1 , I Pascual Calleja1 , V Leon Aguero1 , R Padron Encalada1 , AY Flores1 , L Diaz-Chiron1 , I Silva Conde1 , P Florez Llano1 , A Martinez Leon1 , D Garcia Iglesias1 , L Junquera Vega1 , L Martinez Fernandez1 , L Gutierrez De La Varga1 , P Avanzas Fernandez1 , C Moris De La Tassa1 , 1University Hospital Central de Asturias - Oviedo - Spain ,


Transcatheter mitral valve repair (TMVR) using the Mitraclip® system is an alternative for patients with severe mitral regurgitation (MR) and high surgical risk. Factors affecting survival are under investigation.
Assess the role of right ventricule (RV) systolic function in post-procedure outcomes: survival and heart failure admissions.
Prospective inclusion of patients in whom TMVR was performed between october 2015 and june 2018. RV systolic dysfunction was established as either tricuspid annular plane systolic excursión (TAPSE) less tan 16 mm or systolic tricuspid annular tissue Doppler velocity (TATDV) less tan 9.7 m/s. Chi-square and student´s t-test were use for between group comparisons. Kaplan Meier´s method was used for survival analysis.
44 patients included: 14 with RV systolic dysfunction and 29 with preserved RV systolic function. Basal characteristics are shown in table 1.
Median follow-up was 290 days (interquartile range 90 - 650 days). At one year follow-up, survival rate in patients with RV dysfunction was 74.3% vs 94.12% in patients with preserved RV function (Logrank test = 0.04). Survival free from heart failure admission in the RV systolic dysfunction group was 70.1% vs 78.9% in the group with preserved RV function (Logrank test = 0.3). Mean heart failure admissions during a 12-month period after procedure was 0.8 in the preserved RV function group vs 2.1 in the RV systolic dysfunction one.
RV systolic dysfunction confers a poor prognosis in TMVR patients.

Depressed RV systolic function (15 patients) Normal RV systolic function (29 patients) Significance
Age (years) 74.7 75.4 p=0.4
Male 69% 73% p=0.2
Hypertension 86.7% 72.4% p=0.28
Diabetes Mellitus 40% 24.14% p=0.27
Dilated cardiomyopathy 66.7% 62% p=0.37
Ischaemic cardiomyopathy 60% 48.3% p=0.41
Atrial fibrillation 60% 65.5% p=0.43
Chronic pulmonary obstructive disease 13.5% 22.3% p=0.24
MR functional etiology 75.4% 67.6% p=0.31
Left ventricle ejection fraction 37.6% 43.5% p=0.07
Grade III-IV tricuspid regurgitation 26.7% 28.9% p=0.44

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