MitraClip therapy was successfully implanted in 96% of high-surgical-risk patients with severe mitral regurgitation, yielding significant clinical improvement at discharge with no in-hospital mortality.
Observational (n=51)
Does MitraClip therapy improve acute outcomes and reduce mitral regurgitation in high-surgical-risk patients?
MitraClip therapy is feasible and safe in high-surgical-risk patients with severe MR, including those with adverse valve morphology and severe LV dysfunction, leading to acute clinical improvement.
AIMS: We sought to assess the feasibility of catheter-based mitral valve repair using the MitraClip system in high-surgical-risk patients with mitral regurgitation (MR) > or =grade 3+. METHODS AND RESULTS: MitraClip therapy was performed in 51 consecutive patients 73 +/- 10 years; 34 (67%) men with symptomatic functional n = 35 (69%) or organic MR n = 16 (31%). Mean logistic EuroSCORE was 29 +/- 22%; Society of Thoracic Surgeons score was 15 +/- 11. Left ventricular (LV) ejection fraction was 36 +/- 17%. In 35 patients (69%), adverse mitral valve morphology and/or severe LV dysfunction were present. MitraClip implantation was successful in 49 patients (96%). Most patients n = 34/49 (69%) were treated with a single clip, whereas 14 patients (29%) received two clips and one patient received three clips. Mean device and fluoroscopy times were 105 +/- 65 min and 44 +/- 28 min, respectively. Procedure-related reduction in MR severity was one grade in 16 patients (31%), two grades in 24 patients (47%), and three grades in 9 patients (18%). Forty-four of the 49 successfully treated patients (90%) showed clinical improvement at discharge NYHA functional class > or =III in 48 patients (98%) before and 16 patients (33%) after the procedure (P < 0.0001). There were no procedure-related major adverse events and no in-hospital mortality. CONCLUSION: Mitral valve repair using the MitraClip system was shown to be feasible in patients at high surgical risk primarily determined by an adverse mitral valve morphology and/or severe LV dysfunction.
Franzen et al. (Wed,) conducted a observational in Mitral regurgitation ≥ grade 3+ in high-surgical-risk patients (n=51). MitraClip therapy was evaluated on Successful MitraClip implantation. MitraClip therapy was successfully implanted in 96% of high-surgical-risk patients with severe mitral regurgitation, yielding significant clinical improvement at discharge with no in-hospital mortality.
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