Publications by authors named "Antonio P Rubbio"
Article Synopsis
- Transcatheter mitral edge-to-edge repair (TEER) is a minimally invasive option for treating severe mitral regurgitation in patients with high surgical risk, but there are concerns regarding the risk of cerebrovascular accidents (CVAs) after the procedure.
- In a study of 2,238 patients, the incidence of CVAs was found to be low at 1.47%, with the majority occurring after hospital discharge and linked to preexisting conditions like atrial fibrillation and renal dysfunction.
- While CVAs did not significantly increase the risk of long-term or cardiac death, the study suggests the need for proactive antithrombotic therapy for patients at higher risk before and after TEER.
Article Synopsis
- Researchers studied how heart failure (HF) affects death rates in patients getting a special heart valve repair called M-TEER, focusing on a condition called secondary mitral regurgitation (SMR).
- They found that patients with advanced HF (serious heart problems) had a higher chance of dying in the next two years, but those who got much better SMR results had lower death risks.
- The results showed that improving SMR is important for all patients, whether their heart failure is advanced or not, as it can help them live longer.
Article Synopsis
- Minimally invasive mitral valve repair using the MitraClip device shows beneficial outcomes in patients with significant mitral regurgitation, including those who have had prior valve repairs.
- A study involving 2,238 patients highlighted that while device and procedural success rates are slightly lower for those with previous valve procedures, overall outcomes such as death and rehospitalization rates remain similar across groups.
- The findings suggest that transcatheter edge-to-edge repair is a viable option for carefully selected patients even after previous mitral valve interventions.
Article Synopsis
- Transcatheter edge-to-edge repair (TEER) is an effective, minimally invasive method for treating significant mitral regurgitation and has seen advancements in device technology, specifically the NT, NTr, and XTr MitraClip devices.
- A study analyzed data from a large patient registry to compare these devices, focusing on patient outcomes after the procedure, specifically looking at complications and hospital discharge.
- Results showed that while the NT group faced worse outcomes initially, adjusted analyses indicated no significant differences in long-term results among the devices, suggesting that newer MitraClip devices provide better outcomes even when used on patients with more complex cases.
Background And Aims: Risk stratification for mitral valve transcatheter edge-to-edge repair (M-TEER) is paramount in the decision-making process to appropriately select patients with severe secondary mitral regurgitation (SMR). This study sought to develop and validate an artificial intelligence-derived risk score (EuroSMR score) to predict 1-year outcomes (survival or survival + clinical improvement) in patients with SMR undergoing M-TEER.
Methods: An artificial intelligence-derived risk score was developed from the EuroSMR cohort (4172 and 428 patients treated with M-TEER in the derivation and validation cohorts, respectively).
Atrial functional mitral regurgitation (aFMR) has a peculiar pathophysiology that may have distinctive outcomes. We investigated the impact of transcatheter edge-to-edge repair in aFMR compared with other FMR etiologies. The GIOTTO (GIse registry Of Transcatheter treatment of MR) is a multicenter, prospective study enrolling patients with symptomatic MR treated with MitraClip up to 2020.
View Article and Find Full Text PDFBackground: In the first report from the MitraBridge registry, MitraClip as a bridge to heart transplantation (HTx) proved to be at 1-year an effective treatment strategy for 119 patients with advanced heart failure (HF) who were potential candidates for HTx. We aimed to determine if benefits of MitraClip procedure as a bridge-to-transplant persist up to 2-years.
Methods: By the end of the enrollment period, a total of 153 advanced HF patients (median age 59 years, left ventricular ejection fraction 26.
Background Little is known about the impact of transcatheter mitral valve edge-to-edge repair on changes in left ventricular ejection fraction (LVEF) and the effect of an acute reduction in LVEF on prognosis. We aimed to assess changes in LVEF after transcatheter mitral valve edge-to-edge repair for both primary and secondary mitral regurgitation (PMR and SMR, respectively), identify rates and predictors of LVEF reduction, and estimate its impact on prognosis. Methods and Results In this international multicenter registry, patients with both PMR and SMR undergoing transcatheter mitral valve edge-to-edge repair were included.
View Article and Find Full Text PDFBackground: A risk score was recently derived from the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) Trial. However, external validation of this score is still lacking.
Aims: We aimed to validate the COAPT risk score in a large multicentre population undergoing mitral transcatheter edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR).
Up to half of real-world patients with secondary mitral regurgitation who underwent transcatheter edge-to-edge repair (TEER) do not meet the highly selective COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) criteria. No randomized trials or standardized and validated tools exist to evaluate the risk: benefit ratio of TEER in this specific population. We sought to derive and externally validate a clinical risk score to predict the risk of death or heart failure (HF) hospitalization for COAPT-ineligible patients who underwent TEER (CITE score).
View Article and Find Full Text PDFDespite being highly effective in reducing residual mitral regurgitation and improving outcomes, mitral valve transcatheter edge-to-edge repair (MV-TEER) may be associated with high postprocedural residual mitral gradient (rMG). Conflicting results have been reported regarding the relation between rMG and adverse events. This study aimed to evaluate the predictors and the impact of elevated rMG after MV-TEER on clinical events in patients with functional mitral regurgitation (FMR) at 2 years follow-up.
View Article and Find Full Text PDFArticle Synopsis
- Severe prosthesis-patient mismatch (PPM) is linked to negative outcomes after transcatheter aortic valve replacement (TAVR), and this study investigates its effects in patients undergoing a second TAVR (TAV-in-TAVR).
- The study analyzed data from 155 patients across 28 centers, finding that 6.5% experienced severe PPM and 14.2% moderate PPM, with higher rates in specific TAVR types.
- Results showed that severe PPM correlated with increased one-year all-cause mortality and worsened symptoms, although many patients saw improvement after receiving a new valve to treat the mismatch.
Aim: Randomized controlled trials comparing the use of the MitraClip device in addition to guideline directed medical therapy (GDMT) to GDMT alone in patients with secondary mitral regurgitation (MR) have shown conflicting results. However, if these differences could be due to the underlying MR aetiology is still unknown. Therefore, we aimed to evaluate if the effects of percutaneous edge-to-edge repair with MitraClip implantation could differ in patients with ischaemic (I-MR) and non-ischaemic mitral regurgitation (NI-MR).
View Article and Find Full Text PDFBackground: Mitral-valve transcatheter edge-to-edge repair (MV-TEER) is recommended in patients with severe functional mitral regurgitation (FMR) and in those with degenerative mitral regurgitation (DMR) not eligible to traditional surgery. Patients with a history of previous cardiac surgery are considered at high risk for surgical reintervention, but data are lacking regarding procedural and clinical outcomes.
Objective: aim of this study was to assess the efficacy and clinical results of MV-TEER in patients with previous cardiac surgery enrolled in the "multicentre Italian Society of Interventional Cardiology registry of transcatheter treatment of mitral valve regurgitation" (GIOTTO).
Objectives: This study evaluated the incidence, management, and outcome of patients who experienced MitraClip (Abbott Vascular) failure secondary to loss of leaflet insertion (LLI), single leaflet detachment (SLD), or embolization.
Background: Transcatheter edge-to-edge repair with MitraClip is an established therapy for the treatment of mitral regurgitation (MR), but no data exist regarding the prevalence and outcome according to the mode of clip failure.
Methods: Between January 2009 and December 2020, we retrospectively screened 4,294 procedures of MitraClip performed in 19 centers.
Background: Risk stratification for transcatheter edge-to-edge mitral valve repair (TEER) is paramount in the decision-making process for treating severe mitral regurgitation (MR).
Objectives: This study sought to create and validate a user-friendly score (MitraScore) to predict the risk of mortality in patients undergoing TEER.
Methods: The derivation cohort was based on a multicentric international registry that included 1,119 patients referred for TEER between 2012 and 2020.
We report the challenging case of percutaneous treatment of early recurrent mitral regurgitation after Alfieri edge-to-edge surgical procedure.
View Article and Find Full Text PDFArticle Synopsis
- The study analyzed the outcomes of patients receiving MitraClip treatment for mitral valve regurgitation, comparing those under 80 years old to octogenarians (80+ years).
- A total of 1853 patients were included, with similar in-hospital mortality rates and improvements in mitral regurgitation among both age groups.
- At a 15-month follow-up, while octogenarians had lower rates of rehospitalization and cardiac complications, once adjusting for various baseline characteristics, there were no significant differences in major outcomes between the age groups, indicating the procedure is safe for older patients.
Article Synopsis
- Transcatheter mitral valve repair (TMVR) using MitraClip™ is an effective treatment for mitral regurgitation (MR), with options for implanting one or multiple clips based on the severity of the condition.
- A study analyzed data from the GISE registry, comparing outcomes for patients with one, two, or multiple MitraClips, focusing on 1-year cardiac death or rehospitalization as the primary endpoint.
- The analysis included 1824 patients and revealed significant baseline health differences and procedural variations among those receiving different numbers of MitraClips, impacting clinical outcomes and recovery.
The new iteration of the Portico transcatheter heart valve delivery system, the FlexNav, has been designed to enhance procedural safety and accuracy of the platform. Major technological advancements were the significant reduction of the insertion profile, allowing a transfemoral access down to 5.0 mm vessels, and the addition of a stability layer, improving deployment accuracy and thus potentially reducing implantation depth and permanent pacemaker implantation rate.
View Article and Find Full Text PDFBackground: Available scientific evidence of transcatheter mitral valve repair with the MitraClip comes from randomized controlled trials, which showed controversial results that hardly translate into real-world practice, and from registries of relatively small sample size.
Aim: To collect real-world data in a multicenter, prospective, country-level registry.
Methods And Result: The Italian Society of Interventional Cardiology (GIse) Registry Of Transcatheter Treatment of Mitral Valve RegurgitaTiOn (GIOTTO) is an ongoing single-arm, multicenter, prospective registry that started enrollment in February 2016.
Unlabelled: Limited evidence is available on 5-year clinical outcomes after percutaneous edge-to-edge mitral valve repair.
Methods: The Getting Reduction of mitrAl inSufficiency by Percutaneous clip implantation in ITaly (GRASP-IT) is a multicenter registry including 304 consecutive patients undergoing Mitraclip between October 2008 and October 2013 at 4 Italian centers. Primary end point (all-cause mortality) and secondary end point (all-cause mortality or heart failure [HF] hospitalization) were evaluated up to 5 years and between 1 and 5 years.