MitraClip therapy achieved moderate or less mitral regurgitation at 2 years more frequently in patients with a baseline transmitral mean gradient <3 mm Hg (73% vs 23%, p<0.01).
Cohort (n=74)
Does percutaneous mitral valve repair with the MitraClip system provide durable reduction of mitral regurgitation and what are the predictors of favorable outcomes?
MitraClip therapy demonstrates stable clinical and echocardiographic outcomes up to 2 years, with baseline transmitral gradient <3 mm Hg and LAVI <50 mL/m2 predicting favorable long-term MR reduction.
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/m(2) 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/m(2), 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.
Toggweiler et al. (Tue,) conducted a cohort in Mitral regurgitation (n=74). MitraClip therapy was evaluated on Reduction of mitral regurgitation (MR) to ≤ mild. MitraClip therapy achieved moderate or less mitral regurgitation at 2 years more frequently in patients with a baseline transmitral mean gradient <3 mm Hg (73% vs 23%, p<0.01).