TY  - BOOK
AU  - Thourani, Vinod H
TI  - Pulmonary Venous Waveforms Predict Rehospitalization and Mortality After Percutaneous Mitral Valve Repair
SN  - 1876-7591
PY  - 2019///
KW  - *Cardiac Catheterization/mo [Mortality]
KW  - *Echocardiography, Doppler
KW  - *Echocardiography, Transesophageal
KW  - *Heart Valve Prosthesis Implantation/mo [Mortality]
KW  - *Mitral Valve Insufficiency/su [Surgery]
KW  - *Mitral Valve/su [Surgery]
KW  - *Patient Readmission
KW  - *Pulmonary Veins/dg [Diagnostic Imaging]
KW  - Aged
KW  - Aged, 80 and over
KW  - Atrial Function, Left
KW  - Atrial Pressure
KW  - Cardiac Catheterization/ae [Adverse Effects]
KW  - Cause of Death
KW  - Female
KW  - Heart Valve Prosthesis Implantation/ae [Adverse Effects]
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Mitral Valve Insufficiency/dg [Diagnostic Imaging]
KW  - Mitral Valve Insufficiency/mo [Mortality]
KW  - Mitral Valve Insufficiency/pp [Physiopathology]
KW  - Mitral Valve/dg [Diagnostic Imaging]
KW  - Mitral Valve/pp [Physiopathology]
KW  - Predictive Value of Tests
KW  - Pulmonary Circulation
KW  - Pulmonary Veins/pp [Physiopathology]
KW  - Retrospective Studies
KW  - Risk Assessment
KW  - Risk Factors
KW  - Time Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N2  - BACKGROUND: The effects of hemodynamic changes during percutaneous mitral valve repair (PMVR) with MitraClip (Abbott Vascular, Santa Clara, California) are incompletely characterized; 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; Copyright (c) 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved; 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; 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; 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
UR  - https://dx.doi.org/10.1016/j.jcmg.2018.07.014
ER  -