지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 532 - 541 (10page)
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초록· 키워드
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Background and ObjectivesAge is a traditional risk factor for open-heart surgery. The efficacy and safety of transcatheter edge-to-edge mitral valve repair, using MitraClip (Abbott Vascular), has been demonstrated in patients with severe mitral regurgitation (MR). Since octogenarians or older patients are usually deferred to receive open-heart surgery, the main interest of this study is to elucidate the procedural safety and long-term clinical impact of MitraClip in elderly patients. MethodsPatients with symptomatic severe MR were evaluated by the heart team. For those with high or prohibitive surgical risks, transcatheter mitral valve repair was performed in hybrid operation room. Transthoracic echocardiography (TTE), blood tests, and six-minute walk test (6MWT) were performed before, 1-month, 6-months, and 1 year after index procedure. ResultsA total of 46 consecutive patients receiving MitraClip procedure were enrolled. Nineteen patients (84.2±4.0 years) were over 80-year-old and 27 (73.4±11.1 years) were younger than 80. Compare to baseline, the significant reduction in MR severity was achieved after the procedure and sustained. All the patients benefited from significant improvement in New York Heart Association functional class. The 6-minute walk test (6MWT) increased from 259±114 to 319±92 meters (p=0.03) at 1 year. The overall 1-year survival rate was 80% in the elderly and 88% in those <80 years, p=0.590. Baseline 6MWT was a predictor for all-cause mortality (odds ratio, 0.99; 95% confidence interval, 0.982–0.999; p=0.026) after the MitraClip procedure. ConclusionsTrans-catheter edge-to-edge mitral valve repairs are safe and have positive clinical impact in subjects with severe MR, even in advanced age.
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참고문헌 (29)
참고문헌 신청
Nkomo VT / 2006 / Burden of valvular heart diseases : a population-based study / Lancet 368:1005~1011
Coffey S / 2014 / Lack of progress in valvular heart disease in the pre-transcatheter aortic valve replacement era : increasing deaths and minimal change in mortality rate over the past three decades / Am Heart J 167:562~567
Goel SS / 2014 / Prevalence and outcomes of unoperated patients with severe symptomatic mitral regurgitation and heart failure : comprehensive analysis to determine the potential role of MitraClip for this unmet need / J Am Coll Cardiol 63:185~186
Mirabel M / 2007 / What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery / Eur Heart J 28:1358~1365
Nishimura RA / 2017 / 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease : a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines / J Am Coll Cardiol 70:252~289
Coffey S / 2014 / Lack of progress in valvular heart disease in the pre-transcatheter aortic valve replacement era : increasing deaths and minimal change in mortality rate over the past three decades / Am Heart J 167:562~567
Goel SS / 2014 / Prevalence and outcomes of unoperated patients with severe symptomatic mitral regurgitation and heart failure : comprehensive analysis to determine the potential role of MitraClip for this unmet need / J Am Coll Cardiol 63:185~186
Mirabel M / 2007 / What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery / Eur Heart J 28:1358~1365
Nishimura RA / 2017 / 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease : a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines / J Am Coll Cardiol 70:252~289
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