Monitoring of mitral- and tricuspid valve interventions with CardioMEMS: insights beyond imaging

Varius Dannenberg, Matthias Koschutnik, Carolina Donà, Christian Nitsche, Georg Spinka, Gregor Heitzinger, Katharina Mascherbauer, Andreas Kammerlander, Matthias Schneider, Max-Paul Winter, Philipp Bartko, Georg Goliasch, Christian Hengstenberg, Julia Mascherbauer, Marianne Gwechenberger

Publikation: Beitrag in Fachzeitschrift (peer-reviewed)Artikel in Fachzeitschrift

Abstract

BACKGROUND: Mitral- and tricuspid regurgitation are associated with significant morbidity and mortality and are increasingly treated interventionally. CardioMEMS is a transcutaneously implanted pressure sensor placed in the pulmonary artery that allows invasive measurement of pulmonary artery pressure and cardiac output.

METHODS: This proof-of-concept study aimed to observe hemodynamic changes as determined by CardioMEMS after transcatheter atrioventricular valve interventions, assess the additional value of CardioMEMS on top of echocardiography, and investigate a potential effect of CardioMEMS on outcome. Patients treated with transcatheter mitral- or tricuspid valve interventions (mitral: TMVR, tricuspid: TTVR) or bicaval valve implantation (bi-CAVI) were recruited. All patients were followed for 12 months.

RESULTS: Thirty-six patients were included (4 with CardioMEMS, 32 controls). Patients with CardioMEMS were monitored prior to intervention and 3-12 months thereafter (one received TMVR, one bi-CAVI, one both TMVR and TTVR, and one isolated TTVR). CardioMEMS group: In both patients with TMVR and in the patient with bi-CAVI, mean pulmonary artery pressures decreased (all p<0.001) and cardiac output increased significantly (both TMVR p<0.001 and bi-CAVI p=0.006) while functional parameters, echocardiography, and NT-proBNP were difficult to interpret, unreliable, or both. Changes after TTVR remained inconclusive.

CONCLUSION: Invasive monitoring using CardioMEMS provides important information after mitral- and tricuspid valve interventions. Such data pave the way for a deeper understanding of the prerequisites for optimal patient selection and management for catheter-based interventions.

OriginalspracheEnglisch
Aufsatznummere13961
Seiten (von - bis)e13961
FachzeitschriftEuropean Journal of Clinical Investigation
Jahrgang53
Ausgabenummer6
Frühes Online-Datum29 Jan. 2023
DOIs
PublikationsstatusVeröffentlicht - Juni 2023

ASJC Scopus Sachgebiete

  • Biochemie
  • Klinische Biochemie

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