{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:01:38Z","timestamp":1760122898347,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T00:00:00Z","timestamp":1575244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005971","name":"Deutsche Herzstiftung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005971","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare baseline characteristics and outcomes in patients treated with either 1 or 2 MitraClips in the German TRAMI (<jats:bold>Tra<\/jats:bold>nscatheter <jats:bold>Mi<\/jats:bold>tral Valve Interventions) registry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The MitraClip community seems to silently assume that results should intrinsically be better after implantation of more than one clip, although data is still sparse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 2010\u20132013, 803 patients were enrolled prospectively into TRAMI (461 one\u2010clip and 312 two\u2010clip procedures). Follow\u2010up was performed centrally at 30\u2009days and 1 year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline characteristics of TRAMI\u2010patients with two clips differed significantly from single\u2010clip patients regarding constitutional (more men, taller body height) and heart failure\u2010related factors (larger left ventricular dimensions, reduced left ventricular ejection fraction, more severe heart failure). Also, a significant increase in two\u2010clip procedures over time was present.<\/jats:p><jats:p>After propensity score matching for differing baseline characteristics, residual moderate mitral regurgitation (MR) occurred more frequently after implantation of two clips, whereas residual severe MR could more frequently be observed after one\u2010clip procedures. However, no or mild residual MR at discharge was present in 71.6% after single\u2010clip and in 70.1% after two\u2010clips implantation (<jats:italic>p<\/jats:italic> = .81).<\/jats:p><jats:p>After 1 year, no significant differences regarding mortality or New York Heart Association status could be detected in the propensity matched cohorts. However, TRAMI\u2010patients treated with two clips had a significantly higher incidence of cerebral\u2010vascular events (<jats:italic>p<\/jats:italic> = .02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TRAMI data cannot support the theory that implantation of more than one clip is associated with better clinical outcomes. The finding of more cerebral\u2010vascular events after two\u2010clip procedures might be hypothesis\u2010generating.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28613","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T22:48:49Z","timestamp":1575326929000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Implantation of one versus two MitraClips in the German TRAMI registry: Is more always better?"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5540-1264","authenticated-orcid":false,"given":"Miriam","family":"Puls","sequence":"first","affiliation":[{"name":"Herzzentrum G\u00f6ttingen Universit\u00e4tsmedizin G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Huenlich","sequence":"additional","affiliation":[{"name":"Herzzentrum G\u00f6ttingen Universit\u00e4tsmedizin G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Boekstegers","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kardiologie und Angiologie, Helios Klinikum Siegburg  Siegburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith","family":"Lubos","sequence":"additional","affiliation":[{"name":"Universit\u00e4res Herzzentrum Eppendorf  Hamburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph S.","family":"von Bardeleben","sequence":"additional","affiliation":[{"name":"2. Med. Klinik, Universit\u00e4tsmedizin Mainz  Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas E.","family":"May","sequence":"additional","affiliation":[{"name":"Innere Medizin III, Universit\u00e4tsklinikum T\u00fcbingen, T\u00fcbingen  Germany"},{"name":"Innere Medizin I, Klinikum Memmingen, Memmingen  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Nickenig","sequence":"additional","affiliation":[{"name":"Medizinische Klinik II, Universit\u00e4tsklinikum Bonn, Bonn  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Baldus","sequence":"additional","affiliation":[{"name":"Herzzentrum, Universit\u00e4tsklinikum K\u00f6ln, K\u00f6ln  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horst","family":"Sievert","sequence":"additional","affiliation":[{"name":"Cardio Vascular Center Frankfurt CVC, Frankfurt a.M.  Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taoufik","family":"Ouarrak","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Herzinfarktforschung, Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Senges","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Herzinfarktforschung, Ludwigshafen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Schillinger","sequence":"additional","affiliation":[{"name":"Herzzentrum G\u00f6ttingen Universit\u00e4tsmedizin G\u00f6ttingen  G\u00f6ttingen Germany"},{"name":"Klinik f\u00fcr Kardiologie, Helios Albert\u2010Schweitzer\u2010Klinik Northeim  Northeim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2001.117277"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.07.065"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009355"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.067"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs079"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv627"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.03.077"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24645"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24538"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx044"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.12.018"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.02.094"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJY14M05_10"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.09.039"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV10I2A41"},{"issue":"2","key":"e_1_2_9_18_1","first-page":"146","article-title":"Large atrial thrombus formation after MitraClip implantation: is anticoagulation mandatory?","volume":"20","author":"Bekeredjian R","year":"2011","journal-title":"J Heart Valve Dis"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-17-0781"},{"issue":"5","key":"e_1_2_9_20_1","first-page":"713","article-title":"Stroke and thrombus formation appending to the MitraClip: what is the appropriate anticoagulation regimen?","volume":"22","author":"Hamm K","year":"2013","journal-title":"J Heart Valve Dis"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.28613","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.28613","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.28613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:31:15Z","timestamp":1693960275000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.28613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,2]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1002\/ccd.28613"],"URL":"https:\/\/doi.org\/10.1002\/ccd.28613","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2019,12,2]]},"assertion":[{"value":"2018-08-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}