Clinical outcomes of MitraClip for the treatment of functional mitral regurgitation.
The aim of this study was to report medium-term outcomes of MitraClip implantation in inoperable or high-risk surgical candidates with functional mitral regurgitation (FMR) in our single-centre experience. From October 2008, 109 consecutive patients with FMR underwent MitraClip implantation (mean age 69±9 years; 82% NYHA Class III-IV). Logistic EuroSCORE was 22±16%. Comorbidities included: chronic renal failure (47%), diabetes (22%), COPD (28%). Mean EF was 28±11%; LVEDD was 68±8 mm. Procedural success was 99% and 30-day mortality was 1.8%. At discharge, 87% patients had MR ≤2+. At 12 months, EF was 34.7±10.4% (p=0.002 compared to preoperative value). Actuarial survival at three years was 74.5±7%. Actuarial freedom from MR ≥3+ at 2.5 years was 70±6%. At one-year follow-up, 86% of patients were in NYHA Class I-II. Preoperative pro-BNP level ≥1,600 pg/ml was identified as an independent risk factor of mortality at follow-up. MitraClip therapy for FMR is a valuable alternative to surgery in high-risk patients. Higher preoperative pro-BNP level is a risk factor for mortality at follow-up. Although patients treated in current practice are high-risk, the procedure remains safe and effective in selected patients.
Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy.
Maurizio
M
Taramasso
Francesco
F
Maisano
Azeem
A
Latib
Paolo
P
Denti
Nicola
N
Buzzatti
Micaela
M
Cioni
Giovanni
G
La Canna
Antonio
A
Colombo
Ottavio
O
Alfieri
D000368:Aged; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000453:epidemiology / Q000601:surgery*; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D019736:Prostheses and Implants; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000601:surgery
D020097:Natriuretic Peptide, Brain