Key result
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.
Why the study?
Does 3D vena contracta area reduction after percutaneous mitral valve repair predict improvement in 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?
Absolute Event Rate: 0.22% vs 0.99%
p-value: p=<0.0001
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.
3D VCA reduction may offer prognostic value post-MitraClip; leaves open independent prediction of 6MWD gains in observational data.
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.
No takes yet. Share an insight, caveat, or question.
Dietl et al. (2018) conducted an 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.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: