RT Journal Article
T1 Percutaneous mitral valve repair with MitraClip device inhemodynamically unstable patients: A systematic review
A1 Martínez Gómez, Eduardo
A1 De Agustín Loeches, José Alberto
A1 Viana Tejedor, Ana Teresa
A1 Vivas Balcones, Luis David
A1 Escaned Barbosa, Javier
A1 Fernández Ortiz, Antonio Ignacio
A1 Macaya Miguel, Carlos
A1 Nombela Franco, Luis
AB BackgroundVery few data exist on percutaneous mitral valve repair (PMVr) in unstable patients with concomitant moderate–severe mitral regurgitation (MR). The purpose of this systematic review was to evaluate baseline characteristics, management and clinical outcomes of critically ill patients undergoing PMVr with MitraClip.MethodsWe conducted a systematic review of the published data on MitraClip from its first use in 2003 to December 2020. Studies referring to critically ill patients in cardiogenic shock or acute refractory pulmonary edema were included. A total of 40 publications including 254 patients with significant MR (Grade 4 in 91%) were included.ResultsMean age was 70 ± 12 years with mean Euroscore II and STS of 21 ± 13 and 20.5 ± 16, respectively. Clinical presentation was with cardiogenic shock and acute myocardial infarction in 72.8 and 60.0% of patients, respectively. Device success was achieved in 238 (93.7%) patients with a significant reduction in MR (Grade ≤ 2 in 91.8%, p < .001). The median weaning time from the procedure, to discontinuation of mechanical circulatory or respiratory support, was 2 days (IQR 1–4), with an in-hospital mortality and non-fatal complication rate of 12.6 and 9.1%, respectively. Kaplan–Meier curves estimated an overall mortality rate of 39.1% at 12-month follow-up, with persistent reduction in MR severity for survivors (Grade ≤ 2 in 81.3%) and one case of mitral valve reintervention.ConclusionsPercutaneous mitral valve repair with MitraClip device is a technically feasible and potentially viable management option in high-risk patients with cardiogenic shock or refractory pulmonary edema and concomitant moderate–severe MR. Prospective trials are required to confirm these findings, and definitively determine the value of MitraClip in hemodynamically unstable patients.
PB Wiley
SN 1522-1946
YR 2021
FD 2021-04-15
LK https://hdl.handle.net/20.500.14352/131109
UL https://hdl.handle.net/20.500.14352/131109
LA eng
NO Martinez-Gomez E, McInerney A, Tirado-Conte G, et al. Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review. Catheter Cardiovasc Interv. 2021;98: E617–E625. https://doi.org/10.1002/ccd.29703Martinez-Gomez E, McInerney A, Tirado-Conte G, et al. Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review. Catheter Cardiovasc Interv. 2021;98: E617–E625. https://doi.org/10.1002/ccd.29703Martinez-Gomez E, McInerney A, Tirado-Conte G, et al. Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review. Catheter Cardiovasc Interv. 2021;98: E617–E625. https://doi.org/10.1002/ccd.29703Martinez-Gomez E, McInerney A, Tirado-Conte G, et al. Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review. Catheter Cardiovasc Interv. 2021;98: E617–E625. https://doi.org/10.1002/ccd.29703Martinez-Gomez E, McInerney A, Tirado-Conte G, et al. Percutaneous mitral valve repair with MitraClip device in hemodynamically unstable patients: A systematic review. Catheter Cardiovasc Interv. 2021;98: E617–E625. https://doi.org/10.1002/ccd.29703
DS Docta Complutense
RD 19 may 2026