Authors:	Yokoyama, Hiroaki Ruf, Tobias Friedrich Geyer, Martin Tamm, Alexander R. da Rocha e Silva, Jaqueline Grace Gößler, Theresa Ann Maria Zirbs, Julia Schwidtal, Ben Münzel, Thomas Bardeleben, Ralph Stephan von
Title:	Reverse cardiac remodeling in patients undergoing combination therapy of transcatheter mitral valve repair
Online publication date:	24-May-2023
Year of first publication:	2023
Language:	english
Abstract:	Aims: For patients with severe mitral valve regurgitation (MR), different kinds of transcatheter mitral valve repair (TMVr) exist, targeting the leaflets, annulus, and chordae. The concomitant combination (COMBO) therapy of TMVrs is rarely used as treatment, and there are very few publications about this therapeutic strategy. We evaluated the effect of COMBO-TMVr on the cardiac left chambers and clinical data, including survival. Methods: We included 35 patients at high risk who underwent concomitant sequential transcatheter mitral valve edge-to-edge repair (M-TEER) and another TMVr for severe MR in our hospital between March 2015 and April 2018. Of these, 13 had adequate follow-up transthoracic echocardiography (TTE) up to around 1 year after the procedure. Results: Survival for all patients was 83% at 1 year, 71% at 2 years, and 63% at 3 years, respectively. In the 13 patients with adequate TTE follow-up, M-TEER plus either Cardioband (n = 4), Carillon Mitral Contour System (n = 7), or Neochord (n = 2) were used, respectively. Ten patients had secondary, and three patients primary MR. After 1 year, changes [median (Q1, Q3)] of left ventricular (LV) end-systolic diameter of −9.9 cm (−11.1, 0.4), LV end-diastolic diameter of −3.3 cm (−8.5, 0.0), LV end-systolic volume (LVESV) of −17.4 mL (−32.6, −0.4), LV end-diastolic volume (LVEDV) of −13.5 mL (−15.9, −3.2), LV mass of −19.5 g (−24.2, −7.6), and left atrial volume (LAV) index (LAVi) of −16.4 mL (−23.3, −11.3) were observed. A significant reduction was also seen in the change ratios of LVESV, LVEDV, LV mass, and LAVi, respectively. Conclusion: We found that COMBO therapy of TMVr seems feasible and may support reverse remodeling of left cardiac chambers during 1 year after the procedure in a cohort of patients at high risk.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9116
Version:	Published version
Publication type:	Zeitschriftenaufsatz
Document type specification:	Scientific article
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Frontiers in cardiovascular medicine 10
Pages or article number:	1029103
Publisher:	Frontiers Media
Publisher place:	Lausanne
Issue date:	2023
ISSN:	2297-055X
Publisher DOI:	10.3389/fcvm.2023.1029103
Appears in collections:	DFG-491381577-G