Acute Hemodynamic Changes after Mitraclip Implantation Comparing Patients with Degenerative and Functional Mitral Regurgitation

BackgroundMitraClip (MC) therapy is a percutaneous treatment option for surgical high-risk patients with both degenerative (DMR) and functional mitral regurgitation (FMR). We compared the acute hemodynamic outcomes of MC therapy in DMR and FMR patients.MethodsA total of 339 successfully treated patients (77 ± 9 years; 215 men [63%]; 129 DMR [38%], 210 FMR [62%]; LV ejection fraction 40 ± 17%) were hemodynamically assessed pre- and post-MC.ResultsFMR patients had significantly higher pre- and post-MC filling pressures, as well as higher pulmonary capillary wedge and mean pulmonary artery pressures, than DMR patients, but the increase or decrease in these variables did not differ significantly between etiologies. Cardiac output increased significantly in both groups (DMR: 4.1–4.9 l/min; FMR: 4.1–5.1 l/min; both p < 0.0001); the increase was statistically not different between etiologies (DMR: 0.8 ± 1.1 l/min; FMR: 1.0 ± 1.1 l/min; p = 0.06). With heart rate constant pre- and post-MC, significant increases were also observed in forward stroke volume (DMR: 70–84 ml; FMR: 70–86 ml; both p < 0.0001). The mean left atrial v-wave was statistically not different between etiologies at baseline and decreased significantly after MC (DMR: 26–17 mmHg; FMR: 27–21 mmHg; both p < 0.0001).ConclusionSuccessful MC therapy results acutely in marked increases in cardiac output and forward stroke volume, and a significant decrease in the left atrial v-wave, in both DMR and FMR patients. Our results attest to the beneficial effect of percutaneous mitral valve repair, particularly in the latter patients with generally poorer baseline health.