title: Acute effect of percutaneous MitraClip therapy in patients with haemodynamic decompensation.
abstract: OBJECTIVE
  To evaluate the haemodynamic effect of acute procedural success (APS) after MitraClip therapy in patients with haemodynamic decompensation.
  
  
  RESULTS
  Of 107 patients, 79 achieved APS after MitraClip implantation. The increase in cardiac index (CI) was primarily detected in patients with a low baseline CI (2.0 ± 0.5 to 2.5 ± 5 L/min/m(2), P < 0.001). There was a decrease in left ventricular end-diastolic pressure (LVEDP) (20 ± 5 to 13 ± 5 mmHg, P = 0.002) and mean pulmonary capillary wedge pressure (PCWPm) (20 ± 4 to 16 ± 5 mmHg, P = 0.001) in patients with values >15 mmHg at baseline, and a decrease in mean pulmonary artery systolic (PAPm) (36 ± 4 to 29 ± 7 mmHg P = 0.003) in those with values >30 mmHg before the MitraClip procedure. Patients with decompensation compared with patients with compensation experienced significant reduction in LVEDP (-8.3 ± 11.9 mmHg vs. -0.2 ± 4.5 mmHg, P = 0.009), a reduction in PCWPm (-3.5 ± 5.6 mmHg vs. 1.9 ± 4.7 mmHg, P < 0.001), and a reduction in PAPm (-8 ± 9 mmHg vs. 3 ± 6 mmHg, P < 0.001).
  
  
  CONCLUSIONS
  The favourable haemodynamic effects of MitraClip therapy on CI were primarily detected in patients with low CI before the procedure, and improvements in left-sided filling pressure and PAP were primarily seen in those with elevated values at baseline.
authors.affiliation: Cedars-Sinai Heart Institute, Los Angeles, CA 90048, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Biner
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Siegel
authors.forename: Ted
authors.initials: T
authors.lastname: Feldman
authors.forename: Asim M
authors.initials: AM
authors.lastname: Rafique
authors.forename: Alfredo
authors.initials: A
authors.lastname: Trento
authors.forename: Patrick
authors.initials: P
authors.lastname: Whitlow
authors.forename: Jason
authors.initials: J
authors.lastname: Rogers
authors.forename: Marc
authors.initials: M
authors.lastname: Moon
authors.forename: Brian
authors.initials: B
authors.lastname: Lindman
authors.forename: Alan
authors.initials: A
authors.lastname: Zajarias
authors.forename: Donald
authors.initials: D
authors.lastname: Glower
authors.forename: Saibal
authors.initials: S
authors.lastname: Kar
mesh_terms: D000208:Acute Disease; D000368:Aged; D002302:Cardiac Output; D005240:Feasibility Studies; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D013223:Statistics as Topic; D018608:Ultrasonography, Doppler