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Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome
  1. Stefan Toggweiler1,
  2. Michel Zuber1,2,
  3. Daniel Sürder3,
  4. Patric Biaggi2,4,
  5. Christine Gstrein2,
  6. Tiziano Moccetti3,
  7. Elena Pasotti3,
  8. Oliver Gaemperli2,
  9. Francesco Faletra3,
  10. Iveta Petrova-Slater3,
  11. Jürg Grünenfelder2,4,
  12. Peiman Jamshidi1,
  13. Roberto Corti2,4,
  14. Giovanni Pedrazzini3,
  15. Thomas F Lüscher2 and
  16. Paul Erne1,2
  1. 1Cantonal Hospital Lucerne, Lucerne, Switzerland
  2. 2University Hospital Zurich, Zurich, Switzerland
  3. 3Fondazione Cardiocentro Ticino, Lugano, Switzerland
  4. 4HeartClinic Hirslanden, Zurich, Switzerland
  1. Correspondence to Professor Paul Erne; paul.erne{at}erne-net.ch

Abstract

Objective Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.

Methods Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively.

Results A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m2 at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival.

Conclusions A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m2, the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.

  • VALVULAR DISEASE
  • INTERVENTIONAL CARDIOLOGY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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