Percutaneous mitral valve repair significantly reduced vena contracta area from 0.99 cm2 to 0.22 cm2 and improved six-minute walk distance in patients with severe mitral regurgitation.
Observational (n=29)
No
Does 3D vena contracta area reduction after percutaneous mitral valve repair predict improvement in six-minute walk distance in patients with severe mitral regurgitation?
Direct planimetry of vena contracta area by 3D-transoesophageal echocardiography allows precise quantification of residual mitral regurgitation after MitraClip and provides prognostic information for functional improvement.
Absolute Event Rate: 0.22% vs 0.99%
p-value: p=<0.0001
BACKGROUND: Percutaneous mitral valve repair (PMVR) is increasingly performed in patients with severe mitral regurgitation (MR). Post-procedural MR grading is challenging and an unsettled issue. We hypothesised that the direct planimetry of vena contracta area (VCA) by 3D-transoesophageal echocardiography allows quantifying post-procedural MR and implies further prognostic relevance missed by the usual ordinal scale (grade I-IV). METHODS: Based on a single-centre PMVR registry containing 102 patients, the association of VCA reduction and patients' functional capacity measured as six-minute walk distance (6 MW) was evaluated. 3D-colour-Doppler datasets were available before, during and 4 weeks after PMVR. RESULTS: , p < 0.0001). It remained stable after median time of 33 days (p = 0.999). 6 MW improved after the procedure (257.5 ± 82.5 m vs. 295.7 ± 96.3 m, p < 0.01). Patients with a decrease in VCA less than the median VCA reduction showed a more distinct improvement in 6 MW than patients with better technical result (p < 0.05). This paradoxical finding was driven by inferior results in very large functional MR. CONCLUSIONS: VCA improves the evaluation of small residual MR. Its post-procedural values remain stable during a short-term follow-up and imply prognostic information for the patients' physical improvement. VCA might contribute to a more substantiated estimation of treatment success in the heterogeneous functional MR group.
Dietl et al. (Sat,) conducted a observational in Severe mitral regurgitation (n=29). Percutaneous mitral valve repair (MitraClip) vs. Baseline was evaluated on Vena contracta area (VCA) (p=<0.0001). Percutaneous mitral valve repair significantly reduced vena contracta area from 0.99 cm2 to 0.22 cm2 and improved six-minute walk distance in patients with severe mitral regurgitation.