Mar 22, 2018 - Effects of levosimendan therapy in patients with severe functional ... clinical, functional and prognostic impact of peri-procedural levosimendan.
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Mitral Valve Interventions
P1361 | BEDSIDE Echocardiographic predictors for a single vs. multiclip strategy in percutaneous mitral valve repair B. Goebel 1 , N. Wystub 1 , A. Hamadanchi 1 , I. Rohm 1 , S. Otto 1 , T. Doenst 2 , P.C. Schulze 1 , T.C. Poerner 1 . 1 University Hospital Jena, Department of Internal Medicine I, Jena, Germany; 2 University Hospital Jena, Department of Cardiothoracic Surgery, Jena, Germany Background: Percutaneous mitral valve repair (pMVR) using the MitraClip device has been performed in a wide spectrum of degenerative and functional mitral regurgitant pathologies. In clinical routine, considerable uncertainty remains about the number clips needed to treat an individual patient effectively. Aim of the study was to examine the value of echocardiographic parameters based on 3D color Doppler to predict if a single or a multi-Clip strategy is needed during pMVR. Method: During pMVR procedure a 3D color Doppler dataset of the regurgitation jet and a continuous-wave Doppler (CW) signal were obtained by transesophageal echocardiography before and after each clip implantation. Using multiplanar reconstruction vena contracta area (VCAmean) was calculated as a mean value of all cross-sectional areas of the regurgitation jet quantified frame by frame during systole in a 3D color Doppler dataset. The velocity time integral (VTI) of CW-Doppler signal was divided into subintervals according to the number of 3D color Doppler frames analyzed during systole. Mitral regurgitation volume (RVvca) was calculated as the sum of 8–15 products of VCA and the corresponding VTI subinterval. Results: The study included 118 consecutive patients (age 74±10 years, 80 male gender) with at least moderate to severe MR undergoing pMVR. The main pathology underlying MR was in 31 cases degenerative and in 87 cases functional. According to the number of clips used during pMVR the patients were divided into a group with single-clip (group 1) and a group with multi-clip (group 2) treatment. Conventional echocardiographic parameters included ejection fraction (EF), left ventricular enddiastolic/endsystolic (LVVd / LVVs) and left atrial (LA) volume. The results of echocardiographic parameters are presented in Table 1. ROC curves for the prediction of mild MR (defined as VCAmean
