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5 Publications visible to you, out of a total of 5
Intraprocedural 3D-vena contracta area predicts survival after transcatheter edge-to-edge repair: results from MITRA-PRO registry.

Abstract (Expand)

BACKGROUND: The MITRA-PRO registry revealed residual mitral regurgitation (MR) to be an important predictor of survival following transcatheter edge-to-edge repair (TEER). Intraprocedural MR assessment … using 3D-Vena Contracta Area (VCA) might be a feasible tool to guide mitral TEER procedures. The study aimed to assess the impact of residual MR assessed by 3D-VCA on 1-year mortality. METHODS: 823 patients with residual MR quantification using 3D-VCA in the MITRA-PRO registry, were included in this study. 1-year mortality, NYHA classification and major adverse events were assessed 1-year after mitral TEER. RESULTS: Patients with trace residual MR after mitral TEER were allocated to the 3D-VCA < 0.1 cm(2) group (27.8%), while a 3D-VCA >/= 0.1 < 0.3 cm(2) (55.4%) was considered as mild and a 3D-VCA >/= 0.3 cm(2) (16.8%) as relevant residual MR. One-year mortality was significantly lower in patients with non-relevant residual MR (3D-VCA < 0.1 cm(2): 10.5%; >/= 0.1 < 0.3 cm(2): 16.0%; >/= 0.3: 24.8%, p = 0.003). An increasing 3D-VCA post mitral TEER was associated with a higher 1-year mortality. At a 3D-VCA of 0.07 cm(2) mortality increased significantly (1-year mortality 3D-VCA post mitral TEER >/= 0.07 cm(2): 16.5% vs. < 0.07 cm(2): 7.8%; p = 0.005) indicating a 3D-VCA of 0.07 cm(2) to be a cut-off value for survival in daily practice. CONCLUSIONS: Residual MR assessed by 3D-VCA after TEER is associated with 1-year mortality. Therefore, 3D-VCA is a valuable echocardiographic tool for intraprocedural MR assessment during mitral TEER and achieving a lower 3D-VCA improve patient survival. (German Clinical Trials Register: DRKS00012288). TRIAL REGISTRATION NUMBER: DRKS00012288.

Authors: D. Rottlander, J. Hausleiter, T. Schmitz, A. Bufe, M. Seyfarth, R. S. von Bardeleben, H. Beucher, T. Ouarrak, S. Schneider, P. Boekstegers

Date Published: 26th Jun 2025

Publication Type: Journal

Residual Mitral Regurgitation Predicts Survival Independent of Mitral Valve Pressure Gradient Following Transcatheter Edge-to-Edge Repair.

Abstract

Not specified

Authors: D. Rottlander, J. Hausleiter, T. Schmitz, A. Bufe, M. Seyfarth, R. S. von Bardeleben, H. Beucher, T. Ouarrak, S. Schneider, P. Boekstegers

Date Published: 14th Apr 2025

Publication Type: Journal

Impact of Intraprocedural Residual Mitral Regurgitation on Long-Term Survival: The MITRA-PRO Registry 3-Year Follow-Up.

Abstract

Not specified

Authors: D. Rottlander, J. Hausleiter, T. Schmitz, A. Bufe, M. Seyfarth, R. S. von Bardeleben, H. Beucher, T. Ouarrak, S. Schneider, P. Boekstegers

Date Published: 10th Feb 2025

Publication Type: Journal

Impact of residual mitral regurgitation after transcatheter edge-to-edge repair in atrial functional mitral regurgitation: Results from MITRA-PRO registry.

Abstract (Expand)

BACKGROUND: Transcatheter edge-to-edge repair (TEER) has emerged to address symptomatic atrial functional mitral regurgitation (aFMR) in patients who are at high operative risk. AIMS: No clinical data … is available on the impact of residual mitral regurgitation (MR) following TEER in aFMR compared to ventricular functional MR (vFMR). METHODS: In the MITRA-PRO registry, 846 patients with FMR and MitraScore assessment for residual MR quantification were included (722 patients with vFMR and 124 patients with aFMR). RESULTS: Compared to vFMR similar procedural results in regard of residual MR following TEER were found in aFMR patients (MitraScore post TEER 2.5 +/- 1.8 vs. 2.7 +/- 1.9), while the amount of implanted TEER devices was increased in vFMR. 1-year survival was better in aFMR compared to vFMR regardless of relevant residual MR (MitraScore >/= 4), while 1-year rehospitalization was comparable for both MR entities. Patients with aFMR and mild residual MR had a lower mortality rate (6.6% vs. 10.3%) and rehospitalization rate (29.1% vs. 46.2%) 1 year after mitral TEER. However, in contrast to vFMR a MitraScore >/=4 was no independent predictor of mortality in aFMR indicating a better tolerance toward residual MR. CONCLUSIONS: Residual MR is an independent predictor of 1-year mortality in vFMR patients, whereas in aFMR patients, a MitraScore of >/=4 is associated with higher mortality but is not an independent predictor in multivariate analysis. Therefore, minimizing MR through mitral TEER is crucial for survival in vFMR patients, while aFMR patients tolerate significant residual MR better 1 year after the procedure.

Authors: D. Rottlander, J. Hausleiter, T. Schmitz, A. Bufe, M. Seyfarth, R. S. von Bardeleben, H. Beucher, T. Ouarrak, S. Schneider, P. Boekstegers

Date Published: 4th Nov 2024

Publication Type: Journal

Intraprocedural Residual Mitral Regurgitation and Survival After Transcatheter Edge-to-Edge Repair: Prospective German Multicenter Registry (MITRA-PRO).

Abstract (Expand)

BACKGROUND: Residual mitral regurgitation (MR) is thought to be an important predictor of long-term survival following transcatheter edge-to-edge repair (TEER). Intraprocedural MR assessment using … transesophageal echocardiography could be limited by image quality, hemodynamics, and patient sedation. The MitraScore is a validated multimodal approach for intraprocedural MR assessment during TEER. OBJECTIVES: This study aimed to assess the impact of residual MR using the MitraScore on 1-year mortality. METHODS: Patients undergoing mitral TEER were eligible for inclusion in the prospective, multicenter MITRA-PRO registry (A Prospective Registry Study on 1-Year Mortality and the Prognostic Significance of MitraScore After MitraClip Implantation in Patients With Mitral Regurgitation). Patients with a MitraScore </=3 were defined as patients with mild residual MR after mitral TEER, whereas a MitraScore >/=4 was considered as relevant residual MR. Mortality, rehospitalization, and major adverse events were assessed 1 year after TEER. RESULTS: A MitraScore </=3 was found in 1,059 patients (71.0%), whereas 432 patients revealed a MitraScore >/=4 (29.0%). One-year mortality was significantly lower in patients with nonrelevant residual MR (MitraScore </=3 14.6% vs MitraScore>/=4 22.1%). An almost linear relationship between intraprocedural MitraScore after TEER and mortality was observed. The combined clinical endpoint of mortality and rehospitalization within the 1-year follow-up was also significantly lower in the MitraScore </=3 group (31.5%) than in the MitraScore >/=4 group (40.8%). A subgroup analysis confirmed the predictive value of the MitraScore in patients with primary, secondary, or mixed MR etiologies. CONCLUSIONS: Residual MR assessed by intraprocedural MitraScore after TEER predicts 1-year mortality and rehospitalization. Therefore, the multimodal MitraScore improves MR assessment during mitral TEER and might improve patient survival.(A Prospective Registry Study on 1-Year Mortality and the Prognostic Significance of MitraScore After MitraClip Implantation in Patients With Mitral Regurgitation [MITRA-PRO]; DRKS00012288).

Authors: P. Boekstegers, J. Hausleiter, T. Schmitz, A. Bufe, T. Comberg, M. Seyfarth, C. Frerker, H. Beucher, D. Rottlander, S. Higuchi, T. Ouarrak, S. Schneider

Date Published: 13th Mar 2023

Publication Type: Journal

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