Predictors for efficacy of percutaneous mitral valve repair using the MitraClip system: the results of the MitraSwiss registry.
BACKGROUND
Percutaneous mitral valve repair (MVR) using the MitraClip system has become a valid alternative for patients with severe mitral regurgitation (MR) and high operative risk.


OBJECTIVE
To identify clinical and periprocedural factors that may have an impact on clinical outcome.


METHODS
Multi-centre longitudinal cohort study.


METHODS
Tertiary referral centres.


METHODS
Here we report on the first 100 consecutive patients treated with percutaneous MVR in Switzerland between March 2009 and April 2011. All of them had moderate-severe (3+) or severe (4+) MR, and 62% had functional MR. 82% of the patients were in New York Heart Association (NYHA) class III/IV, mean left ventricular ejection fraction was 48% and the median European System for Cardiac Operative Risk Evaluation was 16.9%.


METHODS
MitraClip implantation performed under echocardiographic and fluoroscopic guidance in general anaesthesia.


METHODS
Clinical, echocardiographic and procedural data were prospectively collected.


RESULTS
Acute procedural success (APS, defined as successful clip implantation with residual MR grade ≤2+) was achieved in 85% of patients. Overall survival at 6 and 12 months was 89.9% (95% CI 81.8 to 94.6) and 84.6% (95% CI 74.7 to 91.0), respectively. Univariate Cox regression analysis identified APS (p=0.0069) and discharge MR grade (p=0.03) as significant predictors of survival.


CONCLUSIONS
In our consecutive cohort of patients, APS was achieved in 85%. APS and residual discharge MR grade are important predictors of mid-term survival after percutaneous MVR.
Department of Cardiology, University Hospital Zurich, Zürich, Switzerland.
Daniel
D
Sürder
Giovanni
G
Pedrazzini
Oliver
O
Gaemperli
Patric
P
Biaggi
Christian
C
Felix
Kaspar
K
Rufibach
Christof Auf
CA
der Maur
Raban
R
Jeger
Peter
P
Buser
Beat A
BA
Kaufmann
Marco
M
Moccetti
David
D
Hürlimann
Ines
I
Bühler
Dominique
D
Bettex
Jacques
J
Scherman
Elena
E
Pasotti
Francesco F
FF
Faletra
Michel
M
Zuber
Tiziano
T
Moccetti
Thomas F
TF
Lüscher
Paul
P
Erne
Jürg
J
Grünenfelder
Roberto
R
Corti
D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D004452:Echocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D012042:Registries; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome
Valvular Disease