| 000 | 03542nam a22005177a 4500 | ||
|---|---|---|---|
| 008 | 210628s20212021 xxu||||| |||| 00| 0 eng d | ||
| 022 | _a0002-9149 | ||
| 024 | _a10.1016/j.amjcard.2021.02.022 [doi] | ||
| 024 | _aS0002-9149(21)00197-1 [pii] | ||
| 040 | _aOvid MEDLINE(R) | ||
| 099 | _a33667453 | ||
| 245 | _aReasons for Screen Failure for Transcatheter Mitral Valve Repair and Replacement. | ||
| 251 | _aAmerican Journal of Cardiology. 148:130-137, 2021 Jun 01. | ||
| 252 | _aAm J Cardiol. 148:130-137, 2021 Jun 01. | ||
| 253 | _aThe American journal of cardiology | ||
| 260 | _c2021 | ||
| 260 | _fFY2021 | ||
| 260 | _p2021 Jun 01 | ||
| 265 | _sppublish | ||
| 266 | _d2021-06-28 | ||
| 501 | _aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 | ||
| 520 | _aDespite an expanding armamentarium of devices, many patients with mitral regurgitation referred for transcatheter mitral valve repair (TMVr) or replacement (TMVR) do not meet strict clinical trial inclusion and exclusion criteria. We sought to understand the rates that patients were excluded from transcatheter mitral valve therapies and reasons why. We retrospectively analyzed the medical charts and correspondence related to patients referred to our tertiary valve center for TMVr or TMVR between June 2016 and September 2019. Patients were screened for eligibility by our structural Heart Team for either TMVr or TMVR. If TMVr or TMVR was not offered, the reason for screen failure was recorded and categorized. Over the 3-year period, 564 patients were referred for TMVr and orTMVR. Out of these, 15.9% were determined to be eligible for, and underwent, surgical repair or replacement. Ninety-two patients (16.3%) underwent TMVr or TMVR. The majority of patients (343 of 564, 60.8%) ultimately did not undergo intervention. The primary reason for exclusion was clinical in 38.5%, issues related to patient preference of care delivery in 38.8%, anatomical in 13.7%, and futility in 9.0%. In contemporary real-world practice, the majority of patients with mitral regurgitation referred for transcatheter therapies are excluded. Clinical trials testing new transcatheter devices should be encouraged to record and report reasons for screen failure and follow these patients to better understand optimal timing of intervention, address challenging anatomies, and, ultimately, improve penetrance of these novel therapies. Copyright (c) 2021. Published by Elsevier Inc. | ||
| 546 | _aEnglish | ||
| 650 | _aIN PROCESS -- NOT YET INDEXED | ||
| 651 | _aMedStar Health Research Institute | ||
| 651 | _aMedStar Heart & Vascular Institute | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 656 | _aInternal Medicine & Pediatrics Residency | ||
| 656 | _aInternal Medicine Residency | ||
| 656 | _aInterventional Cardiology Fellowship | ||
| 657 | _aJournal Article | ||
| 700 | _aBen-Dor, Itsik | ||
| 700 | _aCase, Brian | ||
| 700 | _aCollins, Erin C | ||
| 700 | _aForrestal, Brian | ||
| 700 | _aKhan, Jaffar M | ||
| 700 | _aReddin, Gemma | ||
| 700 | _aRogers, Toby | ||
| 700 | _aSafren, Lowell | ||
| 700 | _aSatler, Lowell F | ||
| 700 | _aShults, Christian | ||
| 700 | _aWaksman, Ron | ||
| 790 | _aBen-Dor I, Case BC, Collins EC, Forrestal BJ, Khan JM, Nasher N, Reddin G, Rogers T, Safren L, Satler L, Shults C, Torguson R, Waksman R | ||
| 856 |
_uhttps://dx.doi.org/10.1016/j.amjcard.2021.02.022 _zhttps://dx.doi.org/10.1016/j.amjcard.2021.02.022 |
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| 942 |
_cART _dArticle |
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| 999 |
_c6533 _d6533 |
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