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Successful Percutaneous Edge-to-Edge Mitral Valve Repair in a Patient With Mediastinal Shift.

ABSTRACT: Mediastinal shift often induces deformation of the esophagus and the cardiac chamber. We describe the case of percutaneous mitral edge-to-edge valve repair in a patient with mediastinal shift. Esophagography enabled the advancement of the transesophageal echocardiography probe without esophageal damage, and transesophageal echocardiography successfully guided the percutaneous mitral edge-to-edge valve repair procedure. (Level of Difficulty: Intermediate.).

SUBMITTER: Ishizu K

PROVIDER: S-EPMC8299760 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Successful Percutaneous Edge-to-Edge Mitral Valve Repair in a Patient With Mediastinal Shift.

Ishizu Kenichi K Isotani Akihiro A Yamaji Kyohei K Shirai Shinichi S Ando Kenji K

JACC. Case reports 20200826 14

Mediastinal shift often induces deformation of the esophagus and the cardiac chamber. We describe the case of percutaneous mitral edge-to-edge valve repair in a patient with mediastinal shift. Esophagography enabled the advancement of the transesophageal echocardiography probe without esophageal damage, and transesophageal echocardiography successfully guided the percutaneous mitral edge-to-edge valve repair procedure. (<b>Level of Difficulty: Intermediate.</b>). ...[more]

PMID: 34317124

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Outcomes of transcatheter edge-to-edge mitral valve repair with percutaneous coronary intervention vs. surgical mitral valve repair with coronary artery bypass grafting.

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Mitral valve transcatheter edge-to-edge repair.

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Project description:BackgroundThe current data regarding outcomes of transcatheter edge-to-edge mitral valve repair with the MitraClip system in the urgent setting has not been well described. Therefore, we sought to evaluate the outcomes of urgent MitraClip procedures compared with non-urgent ones.MethodThe Nationwide Inpatient Sample database years 2011-2017 was used to identify hospitalizations for MitraClip in the urgent setting. Propensity score matching was used to compare the patients who underwent MitraClip in urgent versus non-urgent settings.ResultsA total of 15,993 patients underwent the MitraClip procedures from 2011 to 2017. 3,929 (24.6%) were urgent and 12,064 (75.4%) were non-urgent. Patients in the urgent group were younger (75.08 vs 77.46) and more likely to be African American (p < 0.001). The urgent group had a higher burden of comorbidities such as diabetes, atrial fibrillation, renal failure and pulmonary circulatory disorders. Using multivariable logistic regression, there was no statistically significant difference in mortality between urgent and non-urgent groups (4.2% vs 1.8%, OR 0.64; 95% CI 0.41-1.00, p = 0.051). Using propensity score matching, there was no statistically significant difference in the in-hospital mortality between urgent and non-urgent groups (4.4% vs 2.8%, OR: 1.60, 95% CI: 0.71-3.63, p = 0.254). The risks of acute kidney injury and discharge to an outside facility were higher in the urgent group (p < 0.001).ConclusionNo significant in-hospital mortality for patients who underwent urgent versus non-urgent MitraClip procedures. Therefore, urgent MitraClip procedure might be an acceptable option when indicated.

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Project description: Not available

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Comparison of Outcomes of Edge-to-Edge Mitral Valve Repair Versus Surgical Mitral Valve Repair for Functional Mitral Regurgitation.

Project description:AimsPatients affected by functional mitral regurgitation represent an increasingly high-risk population. Edge-to-edge mitral valve repair (TEER) has emerged as a promising treatment option for these patients. However, there is limited research on the comparative outcomes of TEER versus surgical mitral valve repair (SMVr). This study seeks to compare the demographics, complications, and outcomes of TEER and SMVr based on a real-world analysis of the National Inpatient Sample (NIS) database.Methods and resultsIn the NIS database, from the years 2016 to 2018, a total of 6233 and 2524 patients who underwent SMVr and TEER were selected, respectively. The mean ages of the patients were 65.68 years (SMVr) and 78.40 years (TEER) (p < 0.01). The mortality rate of patients who received SMVr was similar to that of patients who were treated with TEER (1.7% vs. 1.9%, p = 0.603). Patients who underwent SMVr more likely suffered from perioperative complications including cardiogenic shock (2.3% vs. 0.4%, p < 0.001), cardiac arrest (1.7% vs. 1.1%, p = 0.025), and cerebrovascular infarction (0.9% vs. 0.4%, p = 0.013). The average length of hospital stay was longer (8.59 vs. 4.13 days, p < 0.001) for SMVr compared to TEER; however, the average cost of treatment was higher ($218 728.25 vs. $215 071.74, p = 0.031) for TEER compared to SMVr. Multiple logistic regression analysis showed that SMVr was associated with worse adjusted cardiogenic shock (OR, 7.347 [95% CI, 3.574-15.105]; p < 0.01) and acute kidney injury (OR, 2.793 [95% CI, 2.356-3.311]; p < 0.01).ConclusionPatients who underwent TEER demonstrated a notable decrease in postoperative complications and a shorter hospitalization period when compared to those who underwent SMVr.

| S-EPMC11228827 | biostudies-literature

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