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Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures  Stephan Geidel, MD, Peter Wohlmuth,

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Presentation on theme: "Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures  Stephan Geidel, MD, Peter Wohlmuth,"— Presentation transcript:

1 Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures  Stephan Geidel, MD, Peter Wohlmuth, Michael Schmoeckel, MD  The Annals of Thoracic Surgery  Volume 101, Issue 3, Pages (March 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Intraoperative findings in two cases with 2 (A, B) and 5 MitraClips (C, D). (A, B) An 81-year-old man with a EuroSCORE II of 29.67%, organic disease, a left ventricular ejection fraction of 0.40, and a left ventricular end-diastolic dimension of 58 mm had a MitraClip procedure 76 days ago. One clip became detached with ruptured anterior chords and leaflet tissue (segment A1/A2). The clip is only fixed to segment P1/P2 (B shows the tissues from the ventricular side). Mitral valve replacement was performed, and the patient survived. (C, D) A 55-year-old man with a EuroSCORE II of 52.82%, functional disease, a left ventricular ejection fraction of 0.20, a left ventricular end-diastolic dimension of 69 mm, coronary artery disease, and an intraaortic balloon pump had MitraClip procedures 150 and 13 days ago and finally two clips became detached (segment A3), causing an additional regurgitation at P1/A1 (D is the view from the ventricular side). Mitral valve replacement was carried out. Cardiac death occurred 245 days after the operation. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Midterm survival is related to cardiac death. Cardiac-related survival of 33 patients who underwent open heart operations after unsuccessful clipping is shown by the Kaplan-Meier-method. At the time of the operations, patients were 72.6 ± 10.3 years old. During the follow-up period, 7 cardiac-related deaths occurred. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Survival prediction using the EuroSCORE II at the time of surgery was performed by comparing the overall survival given by the Kaplan-Meier-method in patients with higher (>26%, n = 17) or lower (≤26%, n = 16) EuroSCORE II. The score was shown to be an important variable to predict survival of open heart operations in patients with unsuccessful MitraClip procedures (p = ). The calculated score had increased up to a median of 26.5% (25th to 75th percentiles, 18.7% to 37.9%) before the operations. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

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