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Mitral/Tricuspid Valvular Disease

科研文章

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Novel Transcatheter Mitral Valve Prosthesis for Patients With Severe Mitral Annular Calcification 1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry 3-Year Outcomes of Transcatheter Mitral Valve Repair in Patients With Heart Failure The Art of SAPIEN 3 Transcatheter Mitral Valve Replacement in Valve-in-Ring and Valve-in-Mitral-Annular-Calcification Procedures New Evidence Supporting a Novel Conceptual Framework for Distinguishing Proportionate and Disproportionate Functional Mitral Regurgitation Prognostic importance of the transmitral pressure gradient in mitral annular calcification with associated mitral valve dysfunction The Tricuspid Annular Plane Systolic Excursion to Systolic Pulmonary Artery Pressure Index: Association With All-Cause Mortality in Patients With Moderate or Severe Tricuspid Regurgitation Association Between Malignant Mitral Valve Prolapse and Sudden Cardiac Death: A Review Current Status and Future Prospects of Transcatheter Mitral Valve Replacement: JACC State-of-the-Art Review Surgery Does Not Improve Survival in Patients With Isolated Severe Tricuspid Regurgitation
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Original Research25 May 2021

JOURNAL：Eurointervention. Article Link

Incidence and Standardized Definitions of Mitral Valve Leaflet Adverse Events After Transcatheter Mitral Valve Repair: the EXPAND Study

FM Asch, SH Little, GB Mackensen et al. Keywords: mitral valve leaflet adverse events; LAE; definition; MitraClip;

ABSTRACT

BACKGROUND - An independent panel of experts reviewed all investigator-reported cases of mitral valve leaflet adverse events (LAE) after MitraClipTM NTR/XTR in the EXPAND Study.


AIMS - We aimed to report the findings of the expert panel and standardize definitions for LAE.


METHODS - Standard definitions for different types of LAE were formulated and events adjudicated after detailed review by the expert panel.


RESULTS - Enrolling centers reported LAE in 35 cases, 11 leaflet injuries (9 tear, 2 perforation) and 24 single leaflet device attachment (SLDA). The panel confirmed LAE in 20 cases (2.0% incidence), 18 patients had SLDA and 4 had leaflet injury (2 cases had both SLDA and injury). Leaflet injury occurred during device implant and resulted in surgical valve replacement or death. SLDA-alone events were identified during implant (n=2), pre-discharge (7) or at 30 days of follow-up (7) and were resolved (£ 2+ residual MR) with additional clips in 75% of cases.


CONCLUSIONS - Mitral valve repair with MitraClipTM NTR/XTR is safe. The rate of LAE is lower than previously reported using older generation devices. The proposed definitions and findings will help differentiate leaflet injury from inadequate leaflet insertion and SLDA, and provide guidance to consistently diagnose LAE post MitraClipTM.

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