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贫血患者使用MitraClip系统进行经皮二尖瓣修复术。

Percutaneous mitral valve repair using the MitraClip system in patients with anemia.

作者信息

Hellhammer Katharina, Balzer Jan, Zeus Tobias, Rammos Christos, Niebel Svenja, Kubatz Laura, Wagstaff Rabea, Kelm Malte, Rassaf Tienush

机构信息

University Hospital Düsseldorf, Medical Faculty, Dept. of Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstraße 5, 40225 Düsseldorf, Germany.

University Hospital Düsseldorf, Medical Faculty, Dept. of Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Moorenstraße 5, 40225 Düsseldorf, Germany.

出版信息

Int J Cardiol. 2015 Apr 1;184:399-404. doi: 10.1016/j.ijcard.2015.02.081. Epub 2015 Feb 25.

Abstract

BACKGROUND

Patients with anemia show a negative outcome in percutaneous coronary intervention, transcatheter aortic valve replacement and cardiac surgery. The impact of anemia on periprocedural major adverse cardiac and cerebrovascular events (MACCE) and mortality in patients undergoing treatment of severe mitral regurgitation (MR) with percutaneous mitral valve repair using the MitraClip system is not known.

OBJECTIVE

To assess whether percutaneous mitral valve repair with the MitraClip system is safe and effective in patients with anemia.

METHODS AND RESULTS

80 patients with severe and moderate-to-severe MR were included in this open-label observational single-center study. Anemia was prevalent in 51.3% of patients (n=41). MitraClip devices were successfully implanted in 97.6% (n=40) of patients with anemia and in 97.4% (n=38) of patients without anemia (p=0.971). Periprocedural MACCE occurred in 4.9% (n=2) of patients with anemia and 5.1% (n=2) of patients without anemia (p=0.959). Thirty-day mortality was 2.4% (n=1) in patients with anemia and 5.1% (n=2) in patients without anemia (p=0.611). Follow up of up to 12 months showed a significant improvement of NYHA class and quality of life evaluated by the Minnesota Living with Heart Failure Questionnaire in both groups. One-year survival was 80.5% in patients with anemia and 84.6% in patients without anemia (p=0.634).

CONCLUSION

Mitral valve repair with the MitraClip system can be performed safely and efficiently in patients with anemia. Anemia does not affect clinical outcome and quality of life in patients undergoing mitral valve repair.

摘要

背景

贫血患者在经皮冠状动脉介入治疗、经导管主动脉瓣置换术和心脏手术中预后不良。贫血对使用MitraClip系统经皮二尖瓣修复治疗严重二尖瓣反流(MR)患者围手术期主要不良心脑血管事件(MACCE)和死亡率的影响尚不清楚。

目的

评估使用MitraClip系统经皮二尖瓣修复对贫血患者是否安全有效。

方法与结果

本开放标签观察性单中心研究纳入了80例重度和中重度MR患者。51.3%(n = 41)的患者存在贫血。贫血患者中97.6%(n = 40)成功植入MitraClip装置,非贫血患者中97.4%(n = 38)成功植入(p = 0.971)。贫血患者围手术期MACCE发生率为4.9%(n = 2),非贫血患者为5.1%(n = 2)(p = 0.959)。贫血患者30天死亡率为2.4%(n = 1),非贫血患者为5.1%(n = 2)(p = 0.611)。长达一年的随访显示,两组患者的纽约心脏协会(NYHA)心功能分级和通过明尼苏达心力衰竭生活问卷评估的生活质量均有显著改善。贫血患者一年生存率为80.5%,非贫血患者为84.6%(p = 0.634)。

结论

使用MitraClip系统对贫血患者进行二尖瓣修复可以安全有效地进行。贫血不影响二尖瓣修复患者的临床结局和生活质量。

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