Percutaneous mitral valve repair preserves right ventricular function

Annelieke C M J Van Riel, Kirsten Boerlage-Van Dijk, Rianne H A C M De Bruin-Bon, Motoharu Araki, Karel T. Koch, M. Marije Vis, Paola G. Meregalli, Renée B A Van Den Brink, Jan J. Piek, Barbara J M Mulder, Jan Baan, Berto J. Bouma

Research output: Contribution to journalArticle

Abstract

Background Chronic mitral regurgitation (MR) often leads to diminished right ventricular (RV) function due to long-standing pressure and volume overload. Surgical intervention often adds to the preexisting RV dysfunction. Percutaneous mitral valve (MV) repair can reduce MR, but to what extent this affects the right ventricle is unknown.

Methods Consecutive patients scheduled for percutaneous MV repair using the MitraClip system underwent transthoracic echocardiography at baseline and at 1- and 6-month follow-up. RV systolic function was evaluated using five echocardiographic parameters. RV afterload was evaluated using systolic pulmonary arterial pressure and the mean MV pressure gradient. Residual MR was defined as grade ≥ 3 and mitral stenosis (MS) as a mean MV pressure gradient ≥ 5 mm Hg.

Results Sixty-eight patients (52% men; mean age, 75 ± 10 years) were included. Six months after MitraClip implantation, there were no significant changes in any of the RV parameters. MR decreased (P

Conclusions Percutaneous MV repair, in contrast to surgical repair or replacement, does not negatively affect RV function. After repair, RV afterload and New York Heart Association functional class are improved in the case of successful repair but adversely affected in the presence of both residual MR and MS.

Original languageEnglish
Pages (from-to)1098-1106
Number of pages9
JournalJournal of the American Society of Echocardiography
Volume27
Issue number10
DOIs
Publication statusPublished - Oct 1 2014

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Right Ventricular Function
Mitral Valve Insufficiency
Mitral Valve
Mitral Valve Stenosis
Pressure
Right Ventricular Dysfunction
Heart Ventricles
Echocardiography
Arterial Pressure
Lung

Keywords

  • MitraClip
  • Mitral regurgitation
  • Mitral stenosis
  • Percutaneous mitral valve repair
  • Right ventricular function
  • Transthoracic echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Van Riel, A. C. M. J., Boerlage-Van Dijk, K., De Bruin-Bon, R. H. A. C. M., Araki, M., Koch, K. T., Vis, M. M., ... Bouma, B. J. (2014). Percutaneous mitral valve repair preserves right ventricular function. Journal of the American Society of Echocardiography, 27(10), 1098-1106. https://doi.org/10.1016/j.echo.2014.06.001

Percutaneous mitral valve repair preserves right ventricular function. / Van Riel, Annelieke C M J; Boerlage-Van Dijk, Kirsten; De Bruin-Bon, Rianne H A C M; Araki, Motoharu; Koch, Karel T.; Vis, M. Marije; Meregalli, Paola G.; Van Den Brink, Renée B A; Piek, Jan J.; Mulder, Barbara J M; Baan, Jan; Bouma, Berto J.

In: Journal of the American Society of Echocardiography, Vol. 27, No. 10, 01.10.2014, p. 1098-1106.

Research output: Contribution to journalArticle

Van Riel, ACMJ, Boerlage-Van Dijk, K, De Bruin-Bon, RHACM, Araki, M, Koch, KT, Vis, MM, Meregalli, PG, Van Den Brink, RBA, Piek, JJ, Mulder, BJM, Baan, J & Bouma, BJ 2014, 'Percutaneous mitral valve repair preserves right ventricular function', Journal of the American Society of Echocardiography, vol. 27, no. 10, pp. 1098-1106. https://doi.org/10.1016/j.echo.2014.06.001
Van Riel ACMJ, Boerlage-Van Dijk K, De Bruin-Bon RHACM, Araki M, Koch KT, Vis MM et al. Percutaneous mitral valve repair preserves right ventricular function. Journal of the American Society of Echocardiography. 2014 Oct 1;27(10):1098-1106. https://doi.org/10.1016/j.echo.2014.06.001
Van Riel, Annelieke C M J ; Boerlage-Van Dijk, Kirsten ; De Bruin-Bon, Rianne H A C M ; Araki, Motoharu ; Koch, Karel T. ; Vis, M. Marije ; Meregalli, Paola G. ; Van Den Brink, Renée B A ; Piek, Jan J. ; Mulder, Barbara J M ; Baan, Jan ; Bouma, Berto J. / Percutaneous mitral valve repair preserves right ventricular function. In: Journal of the American Society of Echocardiography. 2014 ; Vol. 27, No. 10. pp. 1098-1106.
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abstract = "Background Chronic mitral regurgitation (MR) often leads to diminished right ventricular (RV) function due to long-standing pressure and volume overload. Surgical intervention often adds to the preexisting RV dysfunction. Percutaneous mitral valve (MV) repair can reduce MR, but to what extent this affects the right ventricle is unknown.Methods Consecutive patients scheduled for percutaneous MV repair using the MitraClip system underwent transthoracic echocardiography at baseline and at 1- and 6-month follow-up. RV systolic function was evaluated using five echocardiographic parameters. RV afterload was evaluated using systolic pulmonary arterial pressure and the mean MV pressure gradient. Residual MR was defined as grade ≥ 3 and mitral stenosis (MS) as a mean MV pressure gradient ≥ 5 mm Hg.Results Sixty-eight patients (52{\%} men; mean age, 75 ± 10 years) were included. Six months after MitraClip implantation, there were no significant changes in any of the RV parameters. MR decreased (P Conclusions Percutaneous MV repair, in contrast to surgical repair or replacement, does not negatively affect RV function. After repair, RV afterload and New York Heart Association functional class are improved in the case of successful repair but adversely affected in the presence of both residual MR and MS.",
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N2 - Background Chronic mitral regurgitation (MR) often leads to diminished right ventricular (RV) function due to long-standing pressure and volume overload. Surgical intervention often adds to the preexisting RV dysfunction. Percutaneous mitral valve (MV) repair can reduce MR, but to what extent this affects the right ventricle is unknown.Methods Consecutive patients scheduled for percutaneous MV repair using the MitraClip system underwent transthoracic echocardiography at baseline and at 1- and 6-month follow-up. RV systolic function was evaluated using five echocardiographic parameters. RV afterload was evaluated using systolic pulmonary arterial pressure and the mean MV pressure gradient. Residual MR was defined as grade ≥ 3 and mitral stenosis (MS) as a mean MV pressure gradient ≥ 5 mm Hg.Results Sixty-eight patients (52% men; mean age, 75 ± 10 years) were included. Six months after MitraClip implantation, there were no significant changes in any of the RV parameters. MR decreased (P Conclusions Percutaneous MV repair, in contrast to surgical repair or replacement, does not negatively affect RV function. After repair, RV afterload and New York Heart Association functional class are improved in the case of successful repair but adversely affected in the presence of both residual MR and MS.

AB - Background Chronic mitral regurgitation (MR) often leads to diminished right ventricular (RV) function due to long-standing pressure and volume overload. Surgical intervention often adds to the preexisting RV dysfunction. Percutaneous mitral valve (MV) repair can reduce MR, but to what extent this affects the right ventricle is unknown.Methods Consecutive patients scheduled for percutaneous MV repair using the MitraClip system underwent transthoracic echocardiography at baseline and at 1- and 6-month follow-up. RV systolic function was evaluated using five echocardiographic parameters. RV afterload was evaluated using systolic pulmonary arterial pressure and the mean MV pressure gradient. Residual MR was defined as grade ≥ 3 and mitral stenosis (MS) as a mean MV pressure gradient ≥ 5 mm Hg.Results Sixty-eight patients (52% men; mean age, 75 ± 10 years) were included. Six months after MitraClip implantation, there were no significant changes in any of the RV parameters. MR decreased (P Conclusions Percutaneous MV repair, in contrast to surgical repair or replacement, does not negatively affect RV function. After repair, RV afterload and New York Heart Association functional class are improved in the case of successful repair but adversely affected in the presence of both residual MR and MS.

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