ORAL

ABSTRACTS

April 24–27, 2012

months. Data were prospectively entered into the database and retro-spectively analyzed.

Results: From September 2009 to May 2011, 27 patients with severeMR (3 or 4�) with a mean age of 74.4�12.2 years (17 males and 10females; mean logEuroScore 26.9�12.2, mean LVEF 48.0�18.5%;mean�SD) were treated in our institution. 1.4�1.0 MitraClip™ wereimplanted per patient with procedural success of 92.6% (25 out of 27).63.0% of MR was degenerative in etiology while the remaining 37.0%was functional. 52% of patients did not meet the EVEREST valvecriteria (majority due to flail gap �10mm and coaptation depth�11mm) and adenosine-induced asystole method was employed insome of these patients to appose the mitral leaflets to facilitate grasp.Degree of MR was reduced from 3.5�0.5 to 1.7�0.8 (p�0.001),corresponding to symptom improvement in NYHA from class 3.1�0.4to 2.1�0.7 (p�0.001) while the change in LV ejection fraction wasfrom 48.0�18.5% to 47.4�18.5% (p�0.74). Mean follow up was332�140 days (range: 96-642 days) without in-patient or 30-day mor-tality (2 patients died at 90 and 297 days after procedure due to heartfailure). There is no statistically significant difference in clinical out-come (reduction of MR, NYHA, and mortality) between the functionalMR and degenerative MR.

Conclusion: MitraClip™ was shown to be an effective and safetreatment for patients with both functional and degenerative mitralregurgitation. Majority of patients with successful implant could ben-efit from reduction of MR together with improvement in NYHA class.In our series with more than half of patients not meeting EVERESTvalve criteria, adenosine-induced asystole could facilitate grasping ofmitral leaflets and hence MitraClip™ implantation.

AS-123Outcomes and Management Strategies for Peri-proceduralHemopericardium Complicating Balloon Mitral Valvotomy.Arunkumar Panneerselvam, Manjunath Chollenahally Nanjappa,Dinesha Basavanna, Rajiv Ananthakrishna, Mohan Honnayanayak,Prabhavathi Bhat. Sri Jayadeva Institute of Cardiovascular

Sciences & Research, Bangalore, India.

64S The American Journal of Cardiology� APRIL

Background: The outcomes and management of hemopericardiumcomplicating balloon mitral valvotomy (BMV) has not been studiedadequately. The aim of this study was to determine the incidence ofhemopericardium during BMV and evaluate the optimal treatmentstrategy.

Methods: Out of 1424 consecutive BMVs performed in our institute,29 patients developed hemopericardium. The management strategyadopted and outcomes were analysed.

Results: Hemopericardium occurred in 2% of patients undergoingBMV. In all patients pericardial collection was noted immediately aftertransseptal puncture. In 6 patients (20.7%) there was minimal effusionwithout tamponade and pericardiocentesis was not done. Out of 23patients (79.3%), who underwent immediate pericardiocentesis, 18patients (78.2%) underwent successful BMV in the same sitting. Only4 patients (13.8%) required surgery to treat persistent pericardial col-lection. The site of perforation in patients undergoing surgery weremost commonly the inferior vena cava-right atrial junction, left atrium(LA) posterior wall and LA appendage. The overall mortality rate was6.9% (2 patients).

Conclusion: The incidence of hemopericardium complicating BMVis 2% and is associated with mortality of 6.9%. In hemodynamicallystable patients without tamponade, pericardiocentesis is not requiredand BMV can be completed. In patients undergoing emergency peri-cardiocentesis, BMV can be done safely and successfully (78.2%) inthe same sitting, without the need for any surgical intervention. Only13.8% of patients developing hemopericardium during BMV requiresurgical intervention to manage persistent pericardial collection.

24–27, 2012 ANGIOPLASTY SUMMIT ABSTRACTS/Oral