■评估中度至重度二尖瓣反流(MR)和心源性休克(CS)患者的经导管边缘至边缘修复(TEER)与单独的医疗管理相比是否可以改善预后。
■单中心,回顾性研究在城市三级转诊中心进行.
■拉什大学医学中心,美国。
■2012年至2021年期间出现CS和中度至重度MR的成年患者纳入研究。
■接受Mitraclip的二尖瓣TEER与单独的医疗管理。
■主要不良心血管事件(MACE)定义为心血管死亡,心力衰竭入院,中风,在30天评估心肌梗塞,6个月,和1年。次要结果是30天和6个月时纽约心脏协会(NYHA)分类的变化。
■有28名患者纳入医疗管理,33名患者纳入二尖瓣TEER组。干预组在30天时MACE降低(24.2%vs.46.4%,p≤0.001)和6个月(27%vs.75%,p=0.002),虽然不是在1年(29.4%vs.41.7%,p=0.42)。在30天,与单独的医疗管理相比,二尖瓣TEER组更多的患者提高到NYHAI/II级(10[35.7%]vs.16[50%],p=0.043)。在6个月时,NYHAI/II类没有差异(7[43.7%]与13[54.2%],p=0.63)。
使用Mitraclip™系统的二尖瓣TEER可改善CS患者的中期心血管疾病,但不能改善死亡率。
UNASSIGNED: Assessing if Transcatheter Edge to Edge Repair (TEER) with
Mitraclip™ in patients with moderate to severe mitral regurgitation (MR) and cardiogenic shock (CS) improves outcomes compared to medical management alone.
UNASSIGNED: A single-center, retrospective study was performed in an urban tertiary referral center.
UNASSIGNED: Rush University Medical Center, United States.
UNASSIGNED: Adult patients presenting with CS and moderate to severe MR between 2012 and 2021 were included.
UNASSIGNED: Undergoing Mitral TEER with
Mitraclip versus medical management alone.
UNASSIGNED: Major adverse cardiovascular events (MACE) defined as cardiovascular death, heart failure admission, stroke, and myocardial infarction assessed at 30 days, 6 months, and 1 year. The secondary outcome was a change in New York Heart Association (NYHA) classification at 30 days and 6 months.
UNASSIGNED: There were 28 patients included in the medical management and 33 in the mitral valve TEER groups. There was a decreased MACE in the intervention group at 30 days (24.2 % vs. 46.4 %, p ≤0.001) and 6 months (27 % vs. 75 %, p = 0.002), though not at 1 year (29.4 % vs. 41.7 %, p = 0.42). At 30 days, more patients in the mitral valve TEER group improved to NYHA classes I/II compared to medical management alone (10 [35.7 %] vs. 16 [50 %], p = 0.043). There were no differences in NYHA classes I/II at 6 months (7 [43.7 %] vs. 13 [54.2 %], p = 0.63).
UNASSIGNED: Mitral valve TEER using the
Mitraclip™ system improves mid-term cardiovascular compared to medical management alone in patients with CS but does not improve mortality.