Universität zu Köln

Puls, Miriam, Huenlich, Mark, Boekstegers, Peter, Lubos, Edith, von Bardeleben, Ralph S., May, Andreas E., Nickenig, Georg, Baldus, Stefan, Sievert, Horst, Ouarrak, Taoufik, Senges, Jochen and Schillinger, Wolfgang . Implantation of one versus two MitraClips in the German TRAMI registry: Is more always better? Catheter. Cardiovasc. Interv.. HOBOKEN: WILEY. ISSN 1522-726X

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Abstract

Objectives To compare baseline characteristics and outcomes in patients treated with either 1 or 2 MitraClips in the German TRAMI (Transcatheter Mitral Valve Interventions) registry. Background The MitraClip community seems to silently assume that results should intrinsically be better after implantation of more than one clip, although data is still sparse. Methods In 2010-2013, 803 patients were enrolled prospectively into TRAMI (461 one-clip and 312 two-clip procedures). Follow-up was performed centrally at 30 days and 1 year. Results Baseline characteristics of TRAMI-patients with two clips differed significantly from single-clip patients regarding constitutional (more men, taller body height) and heart failure-related factors (larger left ventricular dimensions, reduced left ventricular ejection fraction, more severe heart failure). Also, a significant increase in two-clip procedures over time was present. After propensity score matching for differing baseline characteristics, residual moderate mitral regurgitation (MR) occurred more frequently after implantation of two clips, whereas residual severe MR could more frequently be observed after one-clip procedures. However, no or mild residual MR at discharge was present in 71.6% after single-clip and in 70.1% after two-clips implantation (p = .81). After 1 year, no significant differences regarding mortality or New York Heart Association status could be detected in the propensity matched cohorts. However, TRAMI-patients treated with two clips had a significantly higher incidence of cerebral-vascular events (p = .02). Conclusions TRAMI data cannot support the theory that implantation of more than one clip is associated with better clinical outcomes. The finding of more cerebral-vascular events after two-clip procedures might be hypothesis-generating.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Puls, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Huenlich, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED Boekstegers, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Lubos, Edith UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bardeleben, Ralph S. UNSPECIFIED UNSPECIFIED UNSPECIFIED May, Andreas E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Sievert, Horst UNSPECIFIED UNSPECIFIED UNSPECIFIED Ouarrak, Taoufik UNSPECIFIED UNSPECIFIED UNSPECIFIED Senges, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Schillinger, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-124930
DOI:	10.1002/ccd.28613
Journal or Publication Title:	Catheter. Cardiovasc. Interv.
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1522-726X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MITRAL-VALVE REPAIR; ATRIAL THROMBUS FORMATION; INTERVENTIONS; PREDICTORS; THERAPY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12493