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

Research output: Journal article (peer-reviewed)Journal article

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.

Original languageEnglish
Article numbere13961
Pages (from-to)e13961
JournalEuropean Journal of Clinical Investigation
Volume53
Issue number6
Early online date29 Jan 2023
DOIs
Publication statusPublished - Jun 2023

Keywords

  • cardiac output
  • mitral- and tricuspid regurgitation
  • pulmonary hypertension
  • valvular diseases

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry

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