Percutaneous Mitral Repair with the MitraClip System in Patients with Mild‐to‐Moderate and Severe Heart Failure: A Single‐Centre Experience. Issue 2 (April 2014)

• Record Type: Journal Article
• Authors: Bozdag‐Turan, Ilkay; Paranskaya, Liliya; Birkemeyer, Ralf; Turan, R. Gökmen; Kische, Stephan; Akin, Ibrahim; Ortak, Jasmin; Stoeckicht, Yannik; Schubert, Jochen; Westphal, Bernd; Nienaber, Christoph A.; Ince, Hüseyin
• Is Part Of: Cardiovascular therapeutics. Volume 32:Issue 2(2014:Apr.)
• Page Start: 66
• Page End: 73
• Publication Date: 2014-04
• Subjects: Cardiovascular pharmacology -- Periodicals; Cardiovascular agents -- Periodicals; Cardiovascular system -- Diseases -- Chemotherapy -- Periodicals; Cardiovascular Agents -- Periodicals; Cardiovascular Diseases -- drug therapy -- Periodicals; Agents cardiovasculaires -- Périodiques; Appareil cardiovasculaire -- Maladies -- Chimiothérapie -- Périodiques; 616.1005
• DOI: 10.1111/1755-5922.12058
• Languages: English
• ISSNs: 1755-5914

Abstract

<abstract abstract-type="main" id="cdr12058-abs-0001"> <title>Summary</title> <sec id="cdr12058-sec-0001" sec-type="section"> <title>Aims</title> <p>Edge‐to‐edge repair of mitral regurgitation (MR) with the MitraClip<sup>®</sup> (MC) system is increasingly applied in advanced heart failure. Our objective was to compare outcomes in patients with mild‐to‐moderate and severe systolic heart failure.</p> </sec> <sec id="cdr12058-sec-0002" sec-type="section"> <title>Methods and results</title> <p>Between February 2010 and July 2012, 121 patients with MR of at least grade 3+ and a mean EuroSCORE II of 10.6% underwent MC implantation. Thirty‐nine had a left ventricular ejection fraction (LVEF) of ≤30% (group A) and 82 of >30% (group B).</p> <p>Procedural success was comparable in both groups (100% vs. 95.2%) with multiple (>2) clip implantation in 34% and 25% of patients, respectively. At 12 months, absolute reduction in MR grade (2.3 vs. 2.2) and relative reduction in mitral valve orifice area (48% vs. 42%) were also comparable. New York Heart Association class had improved independent from baseline LVEF (<italic>P</italic> < 0.001). In‐hospital mortality was low in both groups (2.6% vs. 2.4%), but there was a strong trend for higher 12‐month mortality in group A (34% vs. 18%, <italic>P</italic> = 0.05) with no significant difference in the overall rate of major adverse cerebrovascular and cardiac events (36.8% vs. 28.9%, <italic>P</italic> = 0.38). On multivariate analysis, MR grade after repair was the strongest predictor of mortality (OR 2.121, 95% CI 1.095–4.109), whereas systolic impairment was no independent predictor.</p> </sec> <sec id="cdr12058-sec-0003" sec-type="section"> <title>Conclusions</title> <p>Percutaneous mitral valve repair led to comparable symptomatic improvement in patients with mild‐to‐moderately or severely reduced LV function. LV‐EF < 30% was not an independent predictor of short‐term mortality, which was mainly governed by residual MR after repair.</p> </sec> </abstract>