MitraClip therapy in daily clinical practice: initial results from the German transcatheter mitral valve interventions (TRAMI) registry

作者:Baldus Stephan*; Schillinger Wolfgang; Franzen Olaf; Bekeredjian Raffi; Sievert Horst; Schofer Joachim; Kuck Karl Heinz; Konorza Thomas; Moellmann Helge; Hehrlein Christoph; Ouarrak Taoufik; Senges Jochen; Meinertz Thomas
来源:European Journal of Heart Failure, 2012, 14(9): 1050-1055.
DOI:10.1093/eurjhf/hfs079

摘要

A substantial percentage of patients with mitral regurgitation (MR) in need of mitral valve repair are currently considered not suitable for conventional surgery. In Germany, the largest cohort of patients studied to date has been treated using a percutaneous, catheter-based approach. We report the acute outcomes of patients enrolled in the investigator-initiated German transcatheter mitral valve interventions (TRAMI) registry.
Between January 2009 and August 2011, 486 patients [median age 75 (interquartile range 7080) years; 200 women (41)] were enrolled in the registry (309 retrospectively and 177 prospectively), with 481 patients (99) having undergone percutaneous edge-to-edge therapy for MR using the MitraClip. At baseline, 93 of patients were in New York Heart Association (NYHA) functional class III or IV and 71 of patients had a left ventricular ejection fraction (LVEF) 50. Two-thirds of patients presented with functional MR. Procedural success was achieved in 94 of patients, with grade III present in 93 of patients at baseline yet only 6 post-intervention. Retrospective patients were followed for a median of 183 days, prospective patients for a median of 44 days. The periprocedural complication rate was low, with only minor bleedings as the most significant event. In-hospital and post-discharge mortality was 2.5 and 12.5, respectively.
Data from the German TRAMI registry suggest that MitraClip therapy is a viable treatment option in daily clinical routine for high surgical risk patients with significant MR.

  • 出版日期2012-9