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Prevalence of severe mitral regurgitation eligible for edge-to-edge mitral valve repair (MitraClip)

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Abstract

Objectives

We assessed the prevalence of moderately severe or severe mitral regurgitation (MR) justifying edge-to-edge mitral valve (MV) repair (MitraClip®) in patients attending the University Hospital Wuerzburg, a tertiary care centre located in Wuerzburg, Germany.

Background

Transcatheter edge-to-edge MV repair of advanced MR is a non-surgical treatment option in inoperable and high-risk patients. It is unknown how many patients are potentially eligible for MitraClip® since several anatomical prerequisites of the MV apparatus have to be met for optimal treatment results.

Methods

Using a novel clinical data warehouse we searched for all patients attached to our Department of Internal Medicine from 01/2008 to 01/2012 with moderately severe or severe MR and aged ≥18 years. The current status of their treatment regime and eligibility for MitraClip® was assessed and re-evaluated according to current guidelines and echocardiographic criteria.

Results

The search of electronic medical records amongst 43,690 patients employed an innovative validated text extraction method and identified 331 patients with moderately severe or severe MR who had undergone echocardiographic assessment at our institution. Of these, 125 (38 %) received MV surgery and 206 (62 %) medical therapy only. Most patients not undergoing surgery had secondary MR (70 %). After evaluation of medical and echocardiographic data of medically treated patients (n = 206), 81 (39 %) were potential candidates for MitraClip® therapy, and 90 (44 %) died during the median follow-up time of 23 months.

Conclusion

A large fraction of patients with moderately severe or severe MR but not operated was detected. Medically treated patients had a bad prognosis and about 40 % of them were potential candidates for MitraClip® therapy.

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Acknowledgments

This work was supported by Comprehensive Heart Failure Center Würzburg, Würzburg, Germany (BMBF grant 01EO1004).

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Authors and Affiliations

  1. Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany

    Julia Wallenborn, Stefan Störk, Sebastian Herrmann, Olga Kukuy, Kai Hu, Wolfram Voelker, Georg Ertl & Frank Weidemann

  2. Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany

    Julia Wallenborn, Stefan Störk, Sebastian Herrmann, Olga Kukuy, Kai Hu, Wolfram Voelker, Georg Ertl & Frank Weidemann

  3. Department of Informatics VI, University of Würzburg, Würzburg, Germany

    Georg Fette & Frank Puppe

  4. Department of Cardiothoracic Surgery, Univerity Hospital Würzburg, Würzburg, Germany

    Armin Gorski

  5. Innere Medizin II, Katharinen-Hospital Unna, Obere Husemannstrasse 2, 59423, Unna, Germany

    Frank Weidemann

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  1. Julia Wallenborn
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  2. Stefan Störk
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  3. Sebastian Herrmann
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  4. Olga Kukuy
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  5. Georg Fette
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  9. Wolfram Voelker
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  10. Georg Ertl
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Corresponding author

Correspondence to Frank Weidemann.

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Conflict of interest

F. W. acknowledges a research grant support from Abbott Laboratories, Abbott Park, IL, USA. All other authors declare no conflicts of interest, including any financial relationship with industry relevant to this manuscript.

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Wallenborn, J., Störk, S., Herrmann, S. et al. Prevalence of severe mitral regurgitation eligible for edge-to-edge mitral valve repair (MitraClip). Clin Res Cardiol 105, 699–709 (2016). https://doi.org/10.1007/s00392-016-0975-z

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  • DOI: https://doi.org/10.1007/s00392-016-0975-z

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