B-57 | Change in Left Atrial Pressure on 12-month Heart Failure Outcomes After MitraClip

Transcatheter mitral valve edge-to-edge repair with MitraClip has been shown to reduce symptoms and decrease heart failure (HF) related readmissions in patients with moderate to severe mitral valve regurgitation. Changes in left atrial pressure after MitraClip(s) placement specifically have been associated with symptom improvement. We conducted a single-center retrospective review to assess if a larger reduction in left atrial pressure after MitraClip correlated to better outcomes with fewer readmissions. Methods: A retrospective review of our Mitraclip database of 401 patients who underwent transcatheter mitral valve edge-to-edge repair from 1/01/2017- 7/31/2022 was performed. Patients were excluded if; they died within 30 days of the procedure, had non-HF-related readmissions, had no recorded pre- or post-procedure left atrial pressures, or had an increase in left atrial pressures. Patients were split into those readmitted within 1-year for an HF-related diagnosis and those without any readmission during that timeframe. The pre-and post-procedural left atrial mean and v-wave pressures were recorded. An unpaired t-test was used to evaluate the results. 401 patients were screened, with 204 who met the inclusion criteria. Of those, 148 had no 12-month readmission, and 56 had at least 1 HF-related readmission. Among those without any readmissions, the median change in left atrial mean and v-wave pressure after MitraClip was 10mmHg (IQR 6-13) and 15mmHg (IQR 9.5-21) respectively. For those with HF readmissions, the median change in left atrial mean and v-wave pressure was 7mmHg (IQR 5-11) and 9mmHg (IQR 7-18) respectively. Univariate analysis showed that those without 12-month readmissions had a greater reduction in the left atrial mean and v-wave pressures of an additional 2.5mmHg (95% CI: -4.00 to -1.00, p<0.05) and 6mmHg (95% CI: -7.00 to -2.00, p<0.05) on average respectively. Patients without 12-month readmissions were found on average to have a greater reduction in their mean left atrial and v-wave pressures. With these results in mind, tracking the pre- and post-procedural left atrial mean and v-wave pressures may be beneficial for their abilities to be used as a prognostic indicator.