Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026
Acute Hypoxemic Respiratory Failure Following Mitral Transcatheter Edge-to-Edge Repair: The Role of Aortic Stenosis.
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Sonbol Mark, Bennett Samuel, Pu Alex, Annabathula Rahul, Chahal Diljon, Aalaei-Andabili Seyed Hossein, Gupta Anuj, Shkullaku Melsjian, Vesely Mark, Benitez Michael, Strauss Erik, Mysore Manu, Allaham Haytham
Аннотация
BACKGROUND: The coexistence of severe mitral regurgitation (MR) and mild-to-moderate aortic stenosis (AS) presents diagnostic and therapeutic challenges. Limited data exists on outcomes following mitral transcatheter edge-to-edge repair (M-TEER) therapy in this patient population.
AIMS: This study is aimed to evaluate clinical outcomes following M-TEER in patients with mild-to-modearte AS compared with those without aortic stenosis.
METHODS: A single-center retrospective study was conducted on 238 patients who underwent M-TEER therapy between January 2014 and December 2024. Patients with severe AS, cardiogenic shock, and failed or aborted cases were excluded. We compared patients with mild-to-moderate AS (n = 30) to those without AS (n = 208).
PRIMARY OUTCOME: Acute hypoxemic respiratory failure (AHRF) within 24 h (SpO2 ≤ 90% ≥ 30 min or need for O2/NIV/IMV, adjudicated as cardiogenic).
SECONDARY OUTCOMES: Post-procedural in-hospital mortality, acute kidney injury, hospital length of stay (LOS), 30-day rate of heart failure hospitalization (HFH), and 30-day rate of all-cause readmission. Multivariable logistic regression was used to identify independent predictors of AHRF, hospital LOS, and 30-day HFH.
RESULTS: Following M-TEER, the mild-to-moderate AS group experienced significantly higher rates of AHRF (16.7% vs. 3.8%, p = 0.0142; adjusted OR 4.38, 95% CI 1.36-14.61, p = 0.014). Within the parsimonious adjusted model, AS remained independently associated with AHRF, whereas the other included covariates were not. There was no significant difference in the 30-day rate of all-cause readmission, 30-day rate of HFH, AKI, LOS, or in-hospital mortality between groups.
CONCLUSION: In patients undergoing M-TEER, the presence of mild-to-moderate AS is independently associated with an increased risk of early post-procedural AHRF, without differences in other short-term clinical outcomes. Given the single-center retrospective design and the limited number of clinical events, these findings should be considered hypothesis-generating and warrant validation in larger, prospective, multicenter studies.
AIMS: This study is aimed to evaluate clinical outcomes following M-TEER in patients with mild-to-modearte AS compared with those without aortic stenosis.
METHODS: A single-center retrospective study was conducted on 238 patients who underwent M-TEER therapy between January 2014 and December 2024. Patients with severe AS, cardiogenic shock, and failed or aborted cases were excluded. We compared patients with mild-to-moderate AS (n = 30) to those without AS (n = 208).
PRIMARY OUTCOME: Acute hypoxemic respiratory failure (AHRF) within 24 h (SpO2 ≤ 90% ≥ 30 min or need for O2/NIV/IMV, adjudicated as cardiogenic).
SECONDARY OUTCOMES: Post-procedural in-hospital mortality, acute kidney injury, hospital length of stay (LOS), 30-day rate of heart failure hospitalization (HFH), and 30-day rate of all-cause readmission. Multivariable logistic regression was used to identify independent predictors of AHRF, hospital LOS, and 30-day HFH.
RESULTS: Following M-TEER, the mild-to-moderate AS group experienced significantly higher rates of AHRF (16.7% vs. 3.8%, p = 0.0142; adjusted OR 4.38, 95% CI 1.36-14.61, p = 0.014). Within the parsimonious adjusted model, AS remained independently associated with AHRF, whereas the other included covariates were not. There was no significant difference in the 30-day rate of all-cause readmission, 30-day rate of HFH, AKI, LOS, or in-hospital mortality between groups.
CONCLUSION: In patients undergoing M-TEER, the presence of mild-to-moderate AS is independently associated with an increased risk of early post-procedural AHRF, without differences in other short-term clinical outcomes. Given the single-center retrospective design and the limited number of clinical events, these findings should be considered hypothesis-generating and warrant validation in larger, prospective, multicenter studies.
Предметные рубрики MeSH
HumansRetrospective StudiesMitral Valve InsufficiencyFemaleAortic Valve StenosisMaleRisk FactorsTreatment OutcomeTime FactorsMitral ValveRespiratory InsufficiencyRisk AssessmentAgedSeverity of Illness IndexCardiac CatheterizationAged, 80 and overAcute DiseaseHospital MortalityHypoxiaPatient Readmission