Acute effect of percutaneous MitraClip therapy in patients with haemodynamic decompensation

Simon Biner, Robert J. Siegel, Ted Feldman, Asim M. Rafique, Alfredo Trento, Patrick Whitlow, Jason H Rogers, Marc Moon, Brian Lindman, Alan Zajarias, Donald Glower, Saibal Kar

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26 Scopus citations

Abstract

Aims To evaluate the haemodynamic effect of acute procedural success (APS) after MitraClip therapy in patients with haemodynamic decompensation.Methods and resultsOf 107 patients, 79 achieved APS after MitraClip implantation. The increase in cardiac index (CI) was primarily detected in patients with a low baseline CI (2.0 ± 0.5 to 2.5 ± 5 L/min/m2, P < 0.001). There was a decrease in left ventricular end-diastolic pressure (LVEDP) (20 ± 5 to 13 ± 5 mmHg, P = 0.002) and mean pulmonary capillary wedge pressure (PCWPm) (20 ± 4 to 16 ± 5 mmHg, P = 0.001) in patients with values >15 mmHg at baseline, and a decrease in mean pulmonary artery systolic (PAPm) (36 ± 4 to 29 ± 7 mmHg P = 0.003) in those with values >30 mmHg before the MitraClip procedure. Patients with decompensation compared with patients with compensation experienced significant reduction in LVEDP (8.3 ± 11.9 mmHg vs. 0.2 ± 4.5 mmHg, P = 0.009), a reduction in PCWPm (3.5 ± 5.6 mmHg vs. 1.9 ± 4.7 mmHg, P < 0.001), and a reduction in PAPm (8 ± 9 mmHg vs. 3 ± 6 mmHg, P < 0.001).ConclusionThe favourable haemodynamic effects of MitraClip therapy on CI were primarily detected in patients with low CI before the procedure, and improvements in left-sided filling pressure and PAP were primarily seen in those with elevated values at baseline.

Original languageEnglish (US)
Pages (from-to)939-945
Number of pages7
JournalEuropean Journal of Heart Failure
Volume14
Issue number8
DOIs
StatePublished - Aug 2012

Keywords

  • Haemodynamics
  • MitraClip
  • Mitral regurgitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Biner, S., Siegel, R. J., Feldman, T., Rafique, A. M., Trento, A., Whitlow, P., Rogers, J. H., Moon, M., Lindman, B., Zajarias, A., Glower, D., & Kar, S. (2012). Acute effect of percutaneous MitraClip therapy in patients with haemodynamic decompensation. European Journal of Heart Failure, 14(8), 939-945. https://doi.org/10.1093/eurjhf/hfs069