Relative Impact of Surgical Mitral Repair and MitraClip on Annular Remodeling—A Potential Mechanism for Therapeutic Response to Mitral Repair for Degenerative Mitral Regurgitation
التفاصيل البيبلوغرافية
العنوان:
Relative Impact of Surgical Mitral Repair and MitraClip on Annular Remodeling—A Potential Mechanism for Therapeutic Response to Mitral Repair for Degenerative Mitral Regurgitation
OBJECTIVES: Three-dimensional transesophageal echocardiography (TEE) is widely used to guide decision-making for mitral repair - relative impact of surgical mitral valve repair (MVr) and MitraClip on annular remodeling is unknown. The aim was to determine the impact of both mitral repair strategies on annular geometry, including the primary outcome of annular circumference and area. DESIGN: This was a retrospective observational study of patients who underwent mitral intervention between 2016 and 2020. SETTING: Weill Cornell Medicine, a single large academic medical center. PARTICIPANTS: The population comprised of 50 degenerative mitral regurgitation (MR) patients undergoing MVr. INTERVENTIONS: Elective MVr and transesophageal echocardiography (TEE) MEASUREMENTS AND MAIN RESULTS: MitraClip or surgical MVr patients were matched (1:1) for gender and CAD. Mitral annular geometry indices were quantified on intra-procedural 3D TEE. Mild or less MR on follow-up TTE defined optimal response. MitraClip patients were older (80±8 vs. 66±6;p