Key result
Percutaneous repair using the MitraClip achieved successful mitral valve repair in 91% of high-risk octogenarians with severe mitral regurgitation due to chordae rupture.
Why the study?
Does percutaneous repair using MitraClip improve symptoms and cardiac parameters in high-risk octogenarians with severe mitral regurgitation due to chordae rupture?
Observational (n=98)
Does percutaneous repair using MitraClip improve symptoms and cardiac parameters in high-risk octogenarians with severe mitral regurgitation due to chordae rupture?
Percutaneous repair with MitraClip is feasible, safe, and effective at reducing symptoms and improving cardiac remodeling in high-risk octogenarians with severe mitral regurgitation due to chordae rupture.
Supports MitraClip feasibility in high-risk octogenarians; leaves open efficacy confirmation in randomized trials.
OBJECTIVES: The aim of this study was to assess feasibility and clinical effectiveness of the MitraClip device in octogenarians suffering from severe mitral valve regurgitation due to chordae rupture. BACKGROUND: The MitraClip procedure is a suitable technique in high-risk surgical patients to achieve safe and effective percutaneous repair of mitral valve regurgitation. Octogenarians show cumulative risk and social aspects hindering mitral valve surgery. No data exists regarding the use of the MitraClip device in high-risk octogenarians suffering from mitral valve chordae rupture. METHODS: Between October 2009 and March 2017 98 high-risk octogenarians (society of thoracic surgeons score [STS]: 9.7% ± 0.8) with mitral valve prolapse and consecutively chordae rupture were treated with the MitraClip after interdisciplinary discussion. RESULTS: Successful mitral valve repair was achieved in 91% of the octogenarians. Repair of the mitral valve caused immediate and significant reduction of dyspnoea (NYHA class: 3.5 ± 0.4 vs 2.0 ± 0.3; P < 0.001), cardiac reverse remodeling (LVESD: 39 ± 0.8 vs 35 ± 0.8; P < 0.01) and amelioration of cardiac biomarkers (NTproBNP (4884 ± 52 ng/L vs 2473 ± 210 ng/L; P < 0.05,). Effects were stable over the 12 months observation period. None of our patients died intraprocedurally. CONCLUSIONS: Percutaneous repair of chordae rupture is feasible and safe in high-risk octogenarians. The MitraClip should be considered to repair severe mitral valve regurgitation due to mitral valve chordae rupture in high-risk octogenarians after interdisciplinary discussion even facing a challenging anatomy.
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Geis et al. (2017) conducted an observational in Severe mitral valve regurgitation due to chordae rupture (n=98). MitraClip was evaluated on Successful mitral valve repair. Percutaneous repair using the MitraClip achieved successful mitral valve repair in 91% of high-risk octogenarians with severe mitral regurgitation due to chordae rupture.
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