MITRA-FR and COAPT : Why are the results so different and what are the consequences for the daily routine?

[MITRA-FR and COAPT : Why are the results so different and what are the consequences for the daily routine?] Herz. 2019 Aug 19;: Authors: Friedrichs K, Rudolph V Abstract Percutaneous mitral valve repair with the MitraClip in the COAPT study significantly reduced overall mortality and hospitalization in patients with at least moderate to severe mitral valve regurgitation, in comparison to guideline-compliant drug treatment alone. Consequently, the assumption that secondary mitral regurgitation is more a consequence than the cause of systolic heart failure needs to be revised; however, data from the simultaneously published MITRA-FR study showed no prognostic benefits for patients with advanced heart failure and severely enlarged left ventricle; therefore, MitraClip treatment should only be performed after careful patient selection and heart team decision. With respect to future patient selection further studies are needed to better define cut-offs for treatment or exclusion criteria and to identify patients who profit the most from treatment. Also, new catheter-based techniques and alternative approaches to treat functional mitral regurgitation need to be investigated. PMID: 31428798 [PubMed - as supplied by publisher]
Source: Herz - Category: Cardiology Tags: Herz Source Type: research

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CONCLUSIONS: MitraClip procedure improved life-years and quality of life in patients at high surgical risk and it was also a cost-effective treatment option. PMID: 31516049 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
CONCLUSIONS: A small cohort of patients demonstrated with an elevated TVG higher than 3 mmHg at discharge. This elevation had no impact on clinical improvement, on mortality and hospitalization for heart failure. PMID: 31498114 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
AbstractPurpose of ReviewFunctional mitral regurgitation (FMR) occurs when mitral leaflets are prevented from adequate coaptation by underlying left ventricular (LV) dysfunction, mitral annular dilation, or both. This review aims to clarify the complex clinical issues in FMR, including diagnosis and therapy.Recent FindingsEven mild FMR has been shown to affect survival negatively. FMR is a dynamic condition and can vary within systole and with altered loading conditions. An integrative approach, including qualitative and quantitative echocardiographic data, is mandatory to determine severity of FMR. Treatment of FMR starts...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research
AbstractPurpose of reviewTranscatheter edge-to-edge mitral valve repair (TMVr) has been increasingly used in the treatment of patients with severe symptomatic mitral regurgitation who are at high or prohibitive risk for surgical intervention. Pre-existing pulmonary hypertension is known to pertain worse prognosis for patients who are undergoing surgical intervention. The aim of this review is to discuss the current literature on the effects of pulmonary hypertension on the transcatheter edge-to-edge mitral valve repair outcomes.Recent findingsLarge registry data in patients undergoing TMVr for treatment of severe mitral re...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
Abbott Laboratories’ latest pivotal trial will have the company taking a deeper dive into the treatment of what has been dubbed by some as the “forgotten valve.” The Abbott Park, IL-based has launched an IDE study of the TriClip, a transcatheter tricuspid valve repair system for the treatment of severe tricuspid regurgitation (TR). The TRILUMINATE Pivotal trial will evaluate a catheter-based, non-surgical treatment for patients with severe TR – a condition in which the valve doesn't close properly, allowing blood to flow backward into the heart, which ...
Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular Source Type: news
Authors: Vogelhuber J, Weber M, Sinning JM, Nickenig G Abstract After aortic valve stenosis, mitral regurgitation (MR) is the second most common valvular disease, particulary affecting older patients. Optimal medical treatment within the context of heart failure therapy is the favored first-line therapy for secondary MR. If symptoms persist despite optimal medical therapy, surgical or transcatheter mitral valve repair is indicated (recommendation class IIb). In contrast, surgical treatment is essential for patients with symptomatic primary MR and left-ventricular ejection fraction (LVEF)>30% and justifiable peri...
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
ConclusionsIn patients with severe secondary mitral regurgitation, percutaneous repair added to medical treatment did not significantly reduce the risk of death or hospitalization for heart failure at two years compared with medical treatment alone.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Publication date: Available online 31 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): Nicholas J. Goel, Amit Iyengar, John J. Kelly, Chase R. Brown, Fabliha Kurshan, Pavan Atluri, Michael A. Acker, Zehang Chen, Nimesh D. DesaiAbstractBackgroundPostsurgical readmissions are an increasingly scrutinized marker of healthcare quality. We sought to estimate the risk factors and costs associated with readmissions following mitral valve surgery in a large, nationally-representative cohort.MethodsAdult patients undergoing mitral valve repair or replacement were queried from the National Readmissions Database from 2010 t...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
European Journal of Heart Failure, EarlyView.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Editorial Comment Source Type: research
Tricuspid regurgitation (TR) is common in orthotopic transplanted hearts secondary to endomyocardial biopsies and right heart catheterizations performed for rejection surveillance. The majority of patients develop mild to moderate TR while 7-10% develop severe TR and right heart failure. While there are no established protocols for managing severe TR in transplant recipients, surgical tricuspid valve repair or replacement can be performed if medical therapy fails but are generally limited to low risk patients.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 512 Source Type: research
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