Journal of cardiothoracic and vascular anesthesia · 2019
Predicting the Number of Edge-to-Edge Repair Devices Needed to Adequately Treat Mitral Regurgitation Using Transesophageal Echocardiography.
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Fabbro Michael, Aljure Oscar D, Jain Pankaj
Аннотация
OBJECTIVES: Increased utilization and highly variable costs seen with percutaneous mitral valve edge-to-edge repair have made cost cutting strategies of significant interest. Mitral regurgitation etiology, the number of devices used, and experience all play a role in variability. Currently a paucity of data exists in predicting the number of devices. Any associations found between echocardiography parameters and the number of devices used could help with pre-procedure planning and device placement strategies, ultimately reducing variability and costs.
DESIGN: In this retrospective analysis the authors evaluated the ability of established and novel three-dimensional (3D) mitral regurgitation measures, namely 3D vena contracta area and vena contracta length, to predict the number of devices used. Other factors evaluated include mitral valve area and ejection fraction. All factors were compared using the Mann Whitney rank sum tests.
PARTICIPANTS: Patients over 18 years old undergoing the MitraClip procedure.
SETTING: Catheterization Laboratory.
MAIN RESULTS: No relationship was found between 3D parameters and the number of devices used, but mitral valve area was strongly associated with the use of multiple devices.
CONCLUSION: The 3D parameters of interest were not associated with the use of multiple devices, but the mitral valve area was associated. Further studies are needed to determine if this relationship is predictive.
DESIGN: In this retrospective analysis the authors evaluated the ability of established and novel three-dimensional (3D) mitral regurgitation measures, namely 3D vena contracta area and vena contracta length, to predict the number of devices used. Other factors evaluated include mitral valve area and ejection fraction. All factors were compared using the Mann Whitney rank sum tests.
PARTICIPANTS: Patients over 18 years old undergoing the MitraClip procedure.
SETTING: Catheterization Laboratory.
MAIN RESULTS: No relationship was found between 3D parameters and the number of devices used, but mitral valve area was strongly associated with the use of multiple devices.
CONCLUSION: The 3D parameters of interest were not associated with the use of multiple devices, but the mitral valve area was associated. Further studies are needed to determine if this relationship is predictive.