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Scotti A, Munafò A, Margonato A, et al. Transcatheter therapies for secondary mitral regurgitation in advanced heart failure: what are we aiming for?. Heart Fail Rev. 2021;doi: 10.1007/s10741-021-10148-z.
Scotti, A., Munafò, A., Margonato, A., & Godino, C. (2021). Transcatheter therapies for secondary mitral regurgitation in advanced heart failure: what are we aiming for?. Heart failure reviews, . https://doi.org/10.1007/s10741-021-10148-z
Scotti, Andrea, et al. "Transcatheter therapies for secondary mitral regurgitation in advanced heart failure: what are we aiming for?." Heart failure reviews vol. (2021). doi: https://doi.org/10.1007/s10741-021-10148-z
Scotti A, Munafò A, Margonato A, Godino C. Transcatheter therapies for secondary mitral regurgitation in advanced heart failure: what are we aiming for?. Heart Fail Rev. 2021 Jul 22; doi: 10.1007/s10741-021-10148-z. Epub 2021 Jul 22. PMID: 34291400.
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Heart Fail Rev. 2021 Jul 22; doi: 10.1007/s10741-021-10148-z. Epub 2021 Jul 22.

Transcatheter therapies for secondary mitral regurgitation in advanced heart failure: what are we aiming for?.

Heart failure reviews

Andrea Scotti, Andrea Munafò, Alberto Margonato, Cosmo Godino

Affiliations

  1. Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua Medical School, Via Giustiniani 2, 35128, Padua, Italy. [email protected].
  2. Division of Cardiology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
  3. Division of Cardiology, San Raffaele Scientific Institute, Milan, Italy.

PMID: 34291400 DOI: 10.1007/s10741-021-10148-z

Abstract

A severe secondary mitral regurgitation (SMR) can be found in a significant portion of patients affected by advanced heart failure (AHF). Conventional therapies (optimal medical therapy, devices, surgery) present restricted clinical efficacy in this stage of the left ventricle disease which is burdened by high mortality and morbidity rates. Although the treatment of choice is represented by heart transplantation (HTx), there is an unmet need related to the limited supply of donor hearts (as opposed to the growing prevalence of AHF) and the low eligibility of highly symptomatic patients. In case of concomitant severe SMR, transcatheter mitral valve therapies (repair and replacement) may play a crucial role in this setting. While a direct prognostic improvement after correction of SMR has yet to be proved, AHF patients can benefit from the following: hemodynamic stabilization, symptomatic relief, normalization of pulmonary arterial pressures, and reduction in hospitalizations for acute heart failure. Obtaining these results may lead to the clinical consequences of reaching the HTx in good enough clinical status (bridge to heart transplantation), becoming eligible for the HTx (bridge to HTx candidacy), and being delisted for clinical improvement (bridge to recovery). Therefore, achieving traditional secondary endpoints in patients with AHF and SMR can translate into significant clinical implications.

© 2021. The Author(s).

Keywords: Advanced heart failure; Heart transplantation; Mitral regurgitation; Transcatheter mitral valve repair; Transcatheter mitral valve replacement

References

  1. Nkomo VT, Gardin JM, Skelton TN et al (2006) Burden of valvular heart diseases: a population-based study. Lancet 368:1005–1011. https://doi.org/10.1016/S0140-6736(06)69208-8 - PubMed
  2. Iung B, Vahanian A (2011) Epidemiology of valvular heart disease in the adult. Nat Rev Cardiol 8:162–172. https://doi.org/10.1038/nrcardio.2010.202 - PubMed
  3. Rossi A, Dini FL, Faggiano P et al (2011) Independent prognostic value of functional mitral regurgitation in patients with heart failure. A quantitative analysis of 1256 patients with ischaemic and non-ischaemic dilated cardiomyopathy. Heart 97:1675–1680. https://doi.org/10.1136/hrt.2011.225789 - PubMed
  4. Sannino A, Smith RL, Schiattarella GG et al (2017) Survival and cardiovascular outcomes of patients with secondary mitral regurgitation: a systematic review and meta-analysis. JAMA Cardiol 2:1130–1139. https://doi.org/10.1001/jamacardio.2017.2976 - PubMed
  5. Goliasch G, Bartko PE, Pavo N et al (2018) Refining the prognostic impact of functional mitral regurgitation in chronic heart failure. Eur Heart J 39:39–46. https://doi.org/10.1093/eurheartj/ehx402 - PubMed
  6. Godino C, Scotti A, Munafò A et al (2018) Observed versus predicted mortality after MitraClip treatment in patients with symptomatic heart failure and significant functional mitral regurgitation. Eur J Heart Fail 20:1495–1496 - PubMed
  7. Costanzo MR, Mills RM, Wynne J (2008) Characteristics of “Stage D” heart failure: insights from the Acute Decompensated Heart Failure National Registry Longitudinal Module (ADHERE LM). Am Heart J 155:339–347. https://doi.org/10.1016/j.ahj.2007.10.020 - PubMed
  8. Crespo-Leiro MG, Metra M, Lund LH et al (2018) Advanced heart failure: a position statement of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 20:1505–1535. https://doi.org/10.1002/ejhf.1236 - PubMed
  9. Baumwol J (2017) “I Need Help”—a mnemonic to aid timely referral in advanced heart failure. J Hear Lung Transplant 36:593–594. https://doi.org/10.1016/j.healun.2017.02.010 - PubMed
  10. Eurotransplant International Foundation (2019) annual report. Available at the following website: https://www.eurotransplant.org/wp-content/uploads/2020/06/Annual-Report-2019.pdf - PubMed
  11. Starling RC, Estep JD, Horstmanshof DA et al (2017) Risk assessment and comparative effectiveness of left ventricular assist device and medical management in ambulatory heart failure patients: the ROADMAP study 2-year results. JACC Hear Fail 5:518–527. https://doi.org/10.1016/j.jchf.2017.02.016 - PubMed
  12. Mehra MR, Canter CE, Hannan MM et al (2016) The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: a 10-year update. J Hear Lung Transplant 35:1–23. https://doi.org/10.1016/j.healun.2015.10.023 - PubMed
  13. Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 37:2129–2200m. https://doi.org/10.1093/eurheartj/ehw128 - PubMed
  14. Goldstein DJ, Meyns B, Xie R et al (2019) Third annual report from the ISHLT mechanically assisted circulatory support registry: a comparison of centrifugal and axial continuous-flow left ventricular assist devices. J Hear Lung Transplant 38:352–363. https://doi.org/10.1016/j.healun.2019.02.004 - PubMed
  15. Patel JB, Borgeson DD, Barnes ME et al (2004) Mitral regurgitation in patients with advanced systolic heart failure. J Card Fail 10:285–291. https://doi.org/10.1016/j.cardfail.2003.12.006 - PubMed
  16. Lancellotti P, Garbi M (2018) Progression of secondary mitral regurgitation: from heart failure to valvular heart failure. Eur Heart J Cardiovasc Imaging 19:613–614. https://doi.org/10.1093/ehjci/jey040 - PubMed
  17. Godino C, Sisinni A, Pivato CA et al (2020) Prognostic value of pre-operative atrial fibrillation in patients with secondary mitral regurgitation undergoing MitraClip implantation. Am J Cardiol. https://doi.org/10.1016/j.amjcard.2020.12.043 - PubMed
  18. Otto CM, Nishimura RA, Bonow RO et al (2021) 2020 ACC/AHA guideline for the management of patients with valvular heart disease. J Am Coll Cardiol. https://doi.org/10.1016/j.jacc.2020.11.018 - PubMed
  19. Baumgartner H, Falk V, Bax JJ et al (2017) 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J 38:2739–2786. https://doi.org/10.1093/eurheartj/ehx391 - PubMed
  20. Scotti A, Galasso M, Margonato A, Godino C (2021) Patient selection for trans-catheter mitral valve repair versus replacement: ongoing indications and glimpse to the future. Vessel Plus. https://doi.org/10.20517/2574-1209.2020.68 - PubMed
  21. Taramasso M, Gavazzoni M, Nickenig G, Maisano F (2019) Transcatheter mitral repair and replacement: which procedure for which patient? EuroIntervention 15:867–874. https://doi.org/10.4244/eij-d-19-00743 - PubMed
  22. Lubos E, Schlüter M, Vettorazzi E et al (2014) MitraClip therapy in surgical high-risk patients: identification of echocardiographic variables affecting acute procedural outcome. JACC Cardiovasc Interv 7:394–402. https://doi.org/10.1016/j.jcin.2013.12.198 - PubMed
  23. Braun D, Näbauer M, Massberg S, Hausleiter J (2019) One-stop shop: simultaneous direct mitral annuloplasty and percutaneous mitral edge-to-edge repair in a patient with severe mitral regurgitation. Catheter Cardiovasc Interv 93:E318–E319. https://doi.org/10.1002/ccd.27848 - PubMed
  24. Franzen O, van der Heyden J, Baldus S et al (2011) MitraClip therapy in patients with end-stage systolic heart failure. 569–576. https://doi.org/10.1093/eurjhf/hfr029 - PubMed
  25. Geis NA, Pleger ST, Bekeredjian R et al (2018) Haemodynamic effects of percutaneous mitral valve edge-to-edge repair in patients with end-stage heart failure awaiting heart transplantation. ESC Hear Fail 5:892–901. https://doi.org/10.1002/ehf2.12313 - PubMed
  26. Crimi G, Gritti V, Ghio S et al (2018) MitraClip procedure as ‘bridge to list’, the ultimate therapeutic option for end-stage heart failure patients not eligible for heart transplantation due to severe pulmonary hypertension. Pulm Circ 8.  https://doi.org/10.1177/2045894018791871 - PubMed
  27. Garatti A, Castelvecchio S, Bandera F et al (2015) Mitraclip procedure as a bridge therapy in a patient with heart failure listed for heart transplantation. Ann Thorac Surg 99:1796–1799. https://doi.org/10.1016/j.athoracsur.2014.07.079 - PubMed
  28. Sankar NM, Ramani SS, Anantharaman R, Cherian KM (2018) MitraClip and mitral annuloplasty device as a bridge to transplantation. Asian Cardiovasc Thorac Ann 26:57–59. https://doi.org/10.1177/0218492317738385 - PubMed
  29. Godino C, Scotti A, Agricola E et al (2017) Young patient with advanced heart failure no longer a candidate for heart transplantation after MitraClip® procedure. J Heart Valve Dis 26:234–236 - PubMed
  30. Godino C, Munafò A, Scotti A et al (2020) MitraClip in secondary mitral regurgitation as a bridge to heart transplantation: 1-year outcomes from the International MitraBridge Registry. J Hear Lung Transplant 39:1353–1362. https://doi.org/10.1016/j.healun.2020.09.005 - PubMed
  31. Stone GW, Lindenfeld JA, Abraham WT et al (2018) Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med 379:2307–2318. https://doi.org/10.1056/NEJMoa1806640 - PubMed
  32. Del Val D, Ferreira-Neto AN, Wintzer-Wehekind J et al (2019) Early experience with transcatheter mitral valve replacement: a systematic review. J Am Heart Assoc 8:e013332. https://doi.org/10.1161/JAHA.119.013332 - PubMed
  33. Ludwig S, Kalbacher D, Schofer N et al (2021) Early results of a real-world series with two transapical transcatheter mitral valve replacement devices. Clin Res Cardiol 110:411–420. https://doi.org/10.1007/s00392-020-01757-z - PubMed
  34. Alperi A, Granada JF, Bernier M et al (2021) Current status and future prospects of transcatheter mitral valve replacement. J Am Coll Cardiol 77:3058–3078. https://doi.org/10.1016/j.jacc.2021.04.051 - PubMed
  35. De Weger A, Ewe SH, Delgado V, Bax JJ (2011) First-in-man implantation of a trans-catheter aortic valve in a mitral annuloplasty ring: novel treatment modality for failed mitral valve repair. Eur J Cardio-thoracic Surg 39:1054–1056. https://doi.org/10.1016/j.ejcts.2010.09.021 - PubMed
  36. Schaefer A, Conradi L, Seiffert M et al (2016) Valve-in-valve procedures in failing biological xenografts using a novel balloon-expandable device: experience in aortic, mitral, and tricuspid positions. Thorac Cardiovasc Surg 64:366–373. https://doi.org/10.1055/s-0035-1558647 - PubMed
  37. Ielasi A, Buono A, Medda M et al (2020) Trans-catheter valve-in-valve implantation with a novel balloon expandable device in patients with bioprosthetic heart valve failure: a case series. Cardiovasc Revascularization Med. https://doi.org/10.1016/j.carrev.2020.11.018 - PubMed
  38. Simonato M, Whisenant B, Ribeiro HB et al (2021) Transcatheter mitral valve replacement after surgical repair or replacement comprehensive midterm evaluation of valve-in-valve and valve-in-ring implantation from the VIVID registry. Circulation 143:104–116. https://doi.org/10.1161/CIRCULATIONAHA.120.049088 - PubMed
  39. Brown JM, O’Brien SM, Wu C et al (2009) Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database. J Thorac Cardiovasc Surg 137:82–90. https://doi.org/10.1016/j.jtcvs.2008.08.015 - PubMed
  40. Mylotte D, Andalib A, Thériault-Lauzier P et al (2015) Transcatheter heart valve failure: a systematic review. Eur Heart J 36:1306–1327. https://doi.org/10.1093/eurheartj/ehu388 - PubMed
  41. Sorajja P, Moat N, Badhwar V et al (2019) Initial feasibility study of a new transcatheter mitral prosthesis: the first 100 patients. J Am Coll Cardiol 73:1250–1260. https://doi.org/10.1016/j.jacc.2018.12.066 - PubMed
  42. Piazza N (2018) Transcatheter mitral valve replacement: HighLife. In: EuroPCR. Paris, France - PubMed
  43. Regueiro A, Ye J, Fam N et al (2017) 2-year outcomes after transcatheter mitral valve replacement. JACC Cardiovasc Interv 10:1671–1678. https://doi.org/10.1016/j.jcin.2017.05.032 - PubMed
  44. Bapat V, Rajagopal V, Meduri C et al (2018) Early experience with new transcatheter mitral valve replacement. J Am Coll Cardiol 71:12–21. https://doi.org/10.1016/j.jacc.2017.10.061 - PubMed
  45. Adamo M, Godino C, Giannini C et al (2018) Left ventricular reverse remodelling predicts long‐term outcomes in patients with functional mitral regurgitation undergoing MitraClip therapy: results from a multicentre registry. Eur J Heart Fail 21:ejhf.1343. https://doi.org/10.1002/ejhf.1343 - PubMed
  46. Godino C, Salerno A, Cera M et al (2016) Impact and evolution of right ventricular dysfunction after successful MitraClip implantation in patients with functional mitral regurgitation. IJC Hear Vasc 11:90–98. https://doi.org/10.1016/j.ijcha.2016.05.017 - PubMed

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