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Impact of the learning curve on outcome after transcatheter mitral valve repair: results from the German Mitral Valve Registry

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Abstract

Aims

This analysis from the German Mitral Valve Registry investigates the impact of the learning curve with the MitraClip® technique on procedural success and complications.

Methods and results

Consecutive patients treated since 2009 in centers that performed more than 50 transcatheter mitral repairs were included. Results of the first half of the patients were compared to those of the second. Altogether 496 patients from 10 centers were included. Patients treated later had less common severe heart failure symptoms (patients with NYHA IV: 22.1 vs. 14.5 %, p < 0.05). The EuroSCORE I (22.0 vs. 23.0 %, p = ns) and Society of Thoracic Surgeons (STS) score (7.5 vs. 9.5 %, p = ns) did not differ between both groups. Procedural success was 95.6 % (238/249) in the first cases and 94.7 % (232/245, p = ns) subsequently. Also procedural time (104.3 vs. 119 min, p = ns) and complications did not decrease over time.

Conclusion

A learning curve using the MitraClip® device does not appear to significantly affect acute MR reduction, hospital and 30-day mortality. Most likely, the proctor system leads to already high initial procedure success and relatively short procedure time.

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Conflict of interest

Jakob Ledwoch: None.

Jennifer Franke: None.

Stephan Baldus: Research Grants and lecture fees from Abbott Vascular.

Wolfgang Schillinger: Advisory board, consulting fees, lectures fees and reimbursement for travel expenses from Abbott Vascular.

Raffi Bekeredjian: None.

Peter Boekstegers: None.

Ulrich Hink: Reimbursement for travel expenses from Abbott Vascular.

Karl-Heinz Kuck: None.

Taoufik Ouarrak: None.

Helge Möllmann: Speakers honoraria Abbott Vascular and Edwards Lifesciences.

Georg Nickenig: None.

Jochen Senges: None.

Olaf Franzen: Proctoring and speakers’ office and research grant Abbott Vascular.

Horst Sievert: Study honorary, travel expenses, consulting fees from Access Closure, AGA, Angiomed, Ardian, Arstasis, Atritech, Atrium, Avinger, Bard, Boston Scientific, Bridgepoint, CardioKinetix, CardioMEMS, Coherex, Contego, CSI, EndoCross, EndoTex, Epitek, Evalve, ev3, FlowCardia, Gore, Guidant, Lumen Biomedical, HLT, Kensey Nash, Kyoto Medical, Lifetech, Lutonix, Medinol, Medtronic, NDC, NMT, OAS, Occlutech, Osprey, Ovalis, Pathway, PendraCare, Percardia, pfm Medical, Recor, Rox Medical, Sadra, Sorin, Spectranetics, SquareOne, Trireme, Trivascular, Viacor, Velocimed, Veryan.

Stock options from Cardiokinetix, Access Closure, Velocimed, CoAptus, Lumen Biomedical, Coherex.

Author information

Authors and Affiliations

  1. CardioVascular Center Frankfurt, Frankfurt, Germany

    Jakob Ledwoch, Jennifer Franke & Horst Sievert

  2. Herzzentrum Universitätsklinik, Cologne, Germany

    Stephan Baldus

  3. Universitätsklinik, Göttingen, Germany

    Wolfgang Schillinger

  4. Universitätsklinikum, Heidelberg, Germany

    Raffi Bekeredjian

  5. Klinikum Siegburg, Siegburg, Germany

    Peter Boekstegers

  6. Universitätsmedizin, Mainz, Germany

    Ulrich Hink

  7. Asklepios Klinik St. Georg, Hamburg, Germany

    Karl-Heinz Kuck

  8. Institut für Herzinfarktforschung an der Universität Heidelberg, Ludwigshafen, Germany

    Taoufik Ouarrak & Jochen Senges

  9. Kerckhoff Klinik, Bad Nauheim, Germany

    Helge Möllmann

  10. Universitätsklinikum, Bonn, Germany

    Georg Nickenig

  11. Universitäres Herzzentrum, Hamburg, Germany

    Olaf Franzen

Authors
  1. Jakob Ledwoch
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  2. Jennifer Franke
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  3. Stephan Baldus
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  9. Taoufik Ouarrak
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  11. Georg Nickenig
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  12. Jochen Senges
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  13. Olaf Franzen
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  14. Horst Sievert
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Corresponding author

Correspondence to Horst Sievert.

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Ledwoch, J., Franke, J., Baldus, S. et al. Impact of the learning curve on outcome after transcatheter mitral valve repair: results from the German Mitral Valve Registry. Clin Res Cardiol 103, 930–937 (2014). https://doi.org/10.1007/s00392-014-0734-y

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  • DOI: https://doi.org/10.1007/s00392-014-0734-y

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