SHORT TERM OUTCOMES OF TRANSCATHETER MITRAL VALVE REPLACEMENT- A SINGLE CENTER EXPERIENCE

Jacob, Robin

SHORT TERM OUTCOMES OF TRANSCATHETER MITRAL VALVE REPLACEMENT- A SINGLE CENTER EXPERIENCE

Monday, May 20, 2019

Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)

Robin Jacob, MD , University of Texas at Houston Program, Houston, TX

Dominique J Monlezun, MD, PHD, MPH , University of Texas Health McGovern Medical School Houston, Houston, TX

Tom Nguyen, M.D. , The University of Texas Health Science Center, Houston, TX

Pranav Loyalka, M.D. , university of texas health science center houston, Houston, TX

Prakash Balan, M.D., FSCAI , University of Texas Health Science Center at Houston, Houston, TX

Anthony Estrera, MD , university of texas health science center houston, Houston, TX

Richard W. Smalling, M.D., MSCAI , University of Texas Medical School, Houston, TX

Abhijeet Dhoble, MD, MPH , university of texas health science center houston, Houston, TX

Background
It is well known that the risk of surgical mitral valve replacement in patients with prior sternotomies is high. In the present study, we evaluated the short-term outcomes after transcatheter mitral valve replacement (TMVR) in high-risk patients with severe mitral annular calcification, prior mitral bioprosthesis or ring.

Methods
We retrospectively analyzed clinical outcomes in symptomatic high-risk patients with severe mitral stenosis/regurgitation who underwent TMVR at our institution from 2014 to 2018. The study involved 34 patients, with mean age of 75. Basic demographics and echocardiogram findings were collected. Rates of myocardial infarction (MI), bleeding, vascular complications, acute kidney injury (AKI) were recorded. Outcomes and mortality were recorded up to 30 days.

Results
The in-hospital total and cardiac mortality was 8.8% and 5.9% respectively. No additional mortality was noted at 30-days. The mortality was lowest at 7.7% for both valve in valve (ViV) and mitral annular calcification (MAC), compared to 12.5% for patients undergoing valve in ring (ViR) TMVR. The rates of minor and major bleeding were 0% and 6% respectively. The rates of major and minor vascular complication were 0% and 6% respectively. No incidences of MI or CVA occurred in any of the patients.

Conclusions
The outcomes of TMVR in patients undergoing ViV and MAC are acceptable, whereas for those undergoing ViR are poor. The results are comparable to other published studies.