{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:08:04Z","timestamp":1758946084331,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T00:00:00Z","timestamp":1625875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The predictors and clinical significance of increased Doppler\u2010derived mean diastolic gradient (MG) following transcatheter edge\u2010to\u2010edge mitral valve repair (MVTEER) remain controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to examine baseline correlates of Doppler\u2010derived increased MG post\u2010MVTEER and its impact on intermediate\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients undergoing MVTEER were analyzed retrospectively. Post\u2010MVTEER increased MG was defined as &gt;5\u2009mmHg or aborted clip implantation due to increased MG intraprocedurally. Baseline MG and 3D\u2010guided mitral valve area (MVA) by planimetry were retrospectively available in 233 and 109 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>243 patients were included; 62 (26%) had MG\u2009&gt;\u20095\u2009mmHg post\u2010MVTEER or aborted clip insertion, including 7 (11%) that had aborted clip implantation. Mortality occurred in 63 (26%) during a median follow up of 516\u2009days (IQR 211, 1021). Increased post\u2010MVTEER MG occurred more frequently in females (44% vs. 16%, <jats:italic>p<\/jats:italic>\u2009&lt; \u20090.001), those with baseline MVA &lt;4.0\u00a0cm<jats:sup>2<\/jats:sup> (71% vs. 16%), baseline MG \u22654\u2009mmHg (61% vs. 20%), or multiple clips implanted (33% vs. 21%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.04). Increased post\u2010MVTEER MG was associated with increased subsequent mortality compared to those with normal gradient (HR 1.91 95% CI 1.15\u20133.18 <jats:italic>p<\/jats:italic>\u00a0=\u00a00.016) as was aborted clip insertion compared to all others (HR 5.23 95% CI 2.06\u201313.28 <jats:italic>p<\/jats:italic>\u2009&lt; \u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Smaller baseline MVA and increased baseline MG are associated with increased MG post\u2010MVTEER and patients with a Doppler\u2010derived post\u2010MVTEER MG &gt;5\u2009mmHg suffered excess subsequent mortality. In high risk patients considered for MVTEER, identification of those at risk of iatrogenic mitral stenosis with MVTEER is important as they may be optimally treated with alternate surgical or transcatheter therapies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29867","type":"journal-article","created":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T11:19:00Z","timestamp":1625915940000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical predictors and impact of postoperative mean gradient on outcome after transcatheter edge\u2010to\u2010edge mitral valve repair"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-0170","authenticated-orcid":false,"given":"Didem","family":"Oguz","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ratnasari","family":"Padang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorin V.","family":"Pislaru","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vuyisile T.","family":"Nkomo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil V.","family":"Mankad","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Alkhouli","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayra","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy S.","family":"Reeder","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6082-5379","authenticated-orcid":false,"given":"Mackram F.","family":"Eleid","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charanjit S.","family":"Rihal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy J.","family":"Thaden","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,10]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_11_2_1","DOI":"10.1016\/S0140-6736(06)69208-8"},{"doi-asserted-by":"publisher","key":"e_1_2_11_3_1","DOI":"10.1016\/S0195-668X(03)00201-X"},{"doi-asserted-by":"publisher","key":"e_1_2_11_4_1","DOI":"10.1016\/S0140-6736(18)30473-2"},{"doi-asserted-by":"publisher","key":"e_1_2_11_5_1","DOI":"10.1016\/j.jcin.2014.07.024"},{"doi-asserted-by":"publisher","key":"e_1_2_11_6_1","DOI":"10.1161\/jaha.117.007315"},{"doi-asserted-by":"publisher","key":"e_1_2_11_7_1","DOI":"10.1016\/j.jacc.2015.12.054"},{"doi-asserted-by":"publisher","key":"e_1_2_11_8_1","DOI":"10.1016\/j.amjcard.2016.12.027"},{"doi-asserted-by":"publisher","key":"e_1_2_11_9_1","DOI":"10.1016\/j.jcin.2016.12.280"},{"doi-asserted-by":"publisher","key":"e_1_2_11_10_1","DOI":"10.1161\/JAHA.118.011366"},{"doi-asserted-by":"publisher","key":"e_1_2_11_11_1","DOI":"10.1016\/j.euje.2005.12.014"},{"doi-asserted-by":"publisher","key":"e_1_2_11_12_1","DOI":"10.1016\/j.echo.2014.10.003"},{"doi-asserted-by":"publisher","key":"e_1_2_11_13_1","DOI":"10.1016\/j.echo.2017.01.007"},{"doi-asserted-by":"publisher","key":"e_1_2_11_14_1","DOI":"10.1016\/S0894-7317(03)00335-3"},{"doi-asserted-by":"publisher","key":"e_1_2_11_15_1","DOI":"10.1016\/j.echo.2019.01.003"},{"doi-asserted-by":"publisher","key":"e_1_2_11_16_1","DOI":"10.1016\/j.echo.2011.11.010"},{"doi-asserted-by":"publisher","key":"e_1_2_11_17_1","DOI":"10.1016\/j.echo.2021.01.018"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.29867","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.29867","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.29867","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T15:18:53Z","timestamp":1693149533000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.29867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,10]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,11,15]]}},"alternative-id":["10.1002\/ccd.29867"],"URL":"https:\/\/doi.org\/10.1002\/ccd.29867","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2021,7,10]]},"assertion":[{"value":"2021-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}