1Universitätsklinikum Düsseldorf Klinik für Kardiologie, Pneumologie und Angiologie Düsseldorf, Deutschland
Background
Transcatheter edge-to-edge repair of the mitral valve (M-TEER) is a procedure known for its safety, characterized by low complication rates. However, the optimal level and duration of post-procedural care remain uncertain. The aim of the study was to determine the specific post-procedural time frame during which a major complication might arise, emphasizing the need to identify the appropriate duration for post-procedure surveillance.
Methods
We conducted a retrospective analysis of 865 patients who underwent the M-TEER procedure at the University Hospital Düsseldorf between August 2010 and August 2023. Our analysis focused on the comprehensive examination of all relevant complications, whether they occurred during the periprocedural phase or post-procedurally during the inpatient stay, considering the time point of occurrence or diagnosis.
Results
During the inpatient stay of these 865 patients, we observed the following complications: pericardial effusion in 9 cases (1%), stroke in 7 cases (0.8%), bleeding in 56 cases (6.5%), rhythm disorders requiring intervention in 26 cases (3.0%), and one case of myocardial infarction (0.1%). Of the nine pericardial effusions, seven were detected in the periprocedural period, with the remaining two cases identified within the first 4 hours. Among the seven strokes, two were identified peri-procedurally, two occurred within the first 4 hours, two took place between hours 5 and 24, and one stroke was observed after 24 hours. Regarding bleeding, there were 56 cases documented during the inpatient stay. The majority, specifically 48 cases, occurred within the initial 4 hours, with an additional 7 instances observed between hours 5 and 24. Furthermore, one case of bleeding was recorded after the initial 24-hour period. In the context of rhythm disorders requiring interventions, there were 26 instances identified. The majority of these, totaling 21 cases, were detected within the first 4 hours. One case was observed between 5 and 24 hours, and 4 cases emerged after 24 hours.Furthermore, a single case of myocardial infarction was noted, occurring after 24 hours into the inpatient stay.
Based on this distribution of these complications over time, we categorized three distinct time zones in the post-procedural M-TEER period: within the first 4 hours, 82.8% of the complications occurred, during the 4-24 hours period, 10.1%, and after 24h during discharge, 7.5% of the complications occurred.
Conclusion
Our analysis reveals that M-TEER is a safe procedure characterized by low complication rates. The majority of complications manifest either periprocedurally or within the first 4 hours post-procedure. These findings may provide valuable insights into the recommended duration and level of post-procedural care.
I, Haschemi, Jafer: DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation.