+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Outcomes After Transcatheter Mitral Valve Repair in Patients With Renal Disease

Outcomes After Transcatheter Mitral Valve Repair in Patients With Renal Disease

Circulation. Cardiovascular Interventions 12(2): E007552

Renal disease is associated with poor prognosis despite guideline-directed cardiovascular therapy, and outcomes by sex in this population remain uncertain. Patients (n=5213) who underwent a MitraClip procedure in the National Cardiovascular Data Registry Transcatheter Valve Therapy registry were evaluated for the primary composite outcome of all-cause mortality, stroke, and new requirement for dialysis by creatinine clearance (CrCl). Centers for Medicare and Medicaid Services-linked data were available in 63% of patients (n=3300). CrCl was <60 mL/min in 77% (n=4010) and <30 mL/min in 23% (n=1183) of the cohort. Rates of primary outcome were higher with lower CrCl (>60 mL/min, 1.4%; 30-<60 mL/min, 2.7%; <30 mL/min, 5.2%; dialysis, 7.8%; P<0.001), and all low CrCl groups were independently associated with the primary outcome (30-<60 mL/min: adjusted odds ratio, 2.32; 95% CI, 1.38-3.91; <30 mL/min: adjusted odds ratio, 4.44; 95% CI, 2.63-7.49; dialysis: adjusted hazards ratio, 4.52; 95% CI, 2.08-9.82) when compared with CrCl >60 mL/min. Rates of 1-year mortality were higher with lower CrCl (>60 mL/min, 13.2%; 30-<60 mL/min, 18.8%; <30 mL/min, 29.9%; dialysis, 32.3%; P<0.001), and all low CrCl groups were independently associated with 1-year mortality (30-<60 mL/min: adjusted hazards ratio, 1.50; 95% CI, 1.13-1.99; <30 mL/min: adjusted hazards ratio, 2.38; 95% CI, 1.78-3.20; adjusted hazards ratio: dialysis, 2.44; 95% CI, 1.66-3.57) when compared with CrCl >60 mL/min. The majority of patients who undergo MitraClip have renal disease. Preprocedural renal disease is associated with poor outcomes, particularly in stage 4 or 5 renal disease where 1-year mortality is observed in nearly one-third. Studies to determine how to further optimize outcomes in this population are warranted.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 066446400

Download citation: RISBibTeXText

PMID: 30704286

DOI: 10.1161/circinterventions.118.007552

Related references

Comparison of Transcatheter Mitral Valve Repair Versus Surgical Mitral Valve Repair in Patients With Advanced Kidney Disease (from the National Inpatient Sample). American Journal of Cardiology 121(6): 762-767, 2018

Prognostic value of preprocedural 6-min walk test in patients undergoing transcatheter mitral valve repair-insights from the German transcatheter mitral valve interventions registry. Clinical Research in Cardiology 107(3): 241-248, 2017

Association of Transcatheter Mitral Valve Repair With Quality of Life Outcomes at 30 Days and 1 Year: Analysis of the Transcatheter Valve Therapy Registry. JAMA Cardiology 2018, 2018

Impact of left ventricular function on clinical outcomes of functional mitral regurgitation patients undergoing transcatheter mitral valve repair. Catheterization and Cardiovascular Interventions 88(7): 1124-1133, 2016

Association of chronic kidney disease with in-hospital outcomes of transcatheter mitral valve repair. Indian Heart Journal 70(6): 939-940, 2018

Mitral valve surgery; from median sternotomy to closed chest procedures, from replacement to repair techniques/clinical outcomes of mitral valve repair in mitral regurgitation: a prospective analysis of 100 consecutive patients. Anadolu Kardiyoloji Dergisi 11(8): 745-6; Author Reply 746, 2012

Transcatheter mitral valve repair for functional mitral regurgitation using the Cardioband system: 1 year outcomes. European Heart Journal 2018, 2018

In-hospital outcomes of transcatheter mitral valve repair with Mitraclip in patients with pulmonary hypertension: Insights from the National Inpatient Sample. Catheterization and Cardiovascular Interventions 2018, 2018

Transcatheter Mitral Valve Repair in Surgical High-Risk Patients: Gender-Specific Acute and Long-Term Outcomes. Biomed Research International 2016: 3934842, 2016

Bioprosthetic Mitral Transcatheter Transapical Valve-in-Valve Implantation for Mitral Stenosis in an End-Stage Renal Disease Patient. Journal of Cardiac Surgery 30(9): 697-700, 2016

Prevalence and Outcomes of Mitral Stenosis in Patients Undergoing Transcatheter Aortic Valve Replacement: Findings From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry. Jacc. Cardiovascular Interventions 11(7): 693-702, 2018

Is it worth repairing rheumatic mitral valve disease in children? Long-term outcomes of an aggressive approach to rheumatic mitral valve repair compared to replacement in young patients. Interactive Cardiovascular and Thoracic Surgery 2018, 2018

Percutaneous complete repair of failed mitral valve prosthesis: simultaneous closure of mitral paravalvular leaks and transcatheter mitral valve implantation - single-centre experience. Eurointervention 10(11): 1336-1345, 2015

Combined Mitral and Tricuspid Versus Isolated Mitral Valve Transcatheter Edge-to-Edge Repair in Patients With Symptomatic Valve Regurgitation at High Surgical Risk. Jacc. Cardiovascular Interventions 11(12): 1142-1151, 2018

Mitral valve repair for degenerative mitral valve disease: surgical approach, patient selection and long-term outcomes. Heart 103(21): 1663-1669, 2017