title: Percutaneous mitral valve repair with the MitraClip system according to the predicted risk by the logistic EuroSCORE: preliminary results from the German Transcatheter Mitral Valve Interventions (TRAMI) Registry.
abstract: OBJECTIVE
  To evaluate in-hospital and short-term outcomes of percutaneous mitral valve repair according to patients' logistic EuroSCORE (logEuroSCORE) in a multicenter registry
  
  
  BACKGROUND
  The logEuroSCORE is an established tool to predict the risk of mortality during cardiac surgery. In high-risk patients percutaneous mitral valve repair with the MitraClip system represents a less-invasive alternative
  
  
  METHODS
  Data from 1002 patients, who underwent percutaneous mitral valve repair with the MitraClip system, were analyzed in the German Transcatheter Mitral Valve Interventions (TRAMI) Registry. A logEuroSCORE (mortality risk in %) ≥ 20 was considered high risk
  
  
  RESULTS
  Of all patients, 557 (55.6%) had a logEuroSCORE ≥ 20. Implantation of the MitraClip was successful in 95.5 % (942/986) patients. Moderate residual mitral valve regurgitation was more often detected in patients with a logEuroSCORE ≥ 20 (23.8% vs. 17.1%, respectively, P < 0.05). In patients with a logEuroSCORE ≥ 20 the procedural complication rate was 8.9% (vs. 6.4, n.s.) and the in-hospital MACCE rate 4.9% (vs. 1.4% P < 0.01). The in-hospital mortality rate in patients with a logEuroSCORE ≥ 20 and logEuroSCORE < 20 was 4.3 and 1.1%, respectively (P ≤ 0.01) CONCLUSION: Percutaneous mitral valve repair with the MitraClip system is feasible in patients with a logEuroSCORE ≥ 20 with similar procedural results compared to patients with lower predicted risk. Although mortality was four times higher than in patients with logEuroSCORE < 20, mortality in high risk patients was lower than predicted. In those with a logEuroSCORE ≥ 20, moderate residual mitral valve regurgitation was more frequent.
authors.affiliation: CardioVascular Center Frankfurt, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wiebe
authors.forename: Jennifer
authors.initials: J
authors.lastname: Franke
authors.forename: Edith
authors.initials: E
authors.lastname: Lubos
authors.forename: Peter
authors.initials: P
authors.lastname: Boekstegers
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schillinger
authors.forename: Taoufik
authors.initials: T
authors.lastname: Ouarrak
authors.forename: Andreas E
authors.initials: AE
authors.lastname: May
authors.forename: Holger
authors.initials: H
authors.lastname: Eggebrecht
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Stephan
authors.initials: S
authors.lastname: Baldus
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Horst
authors.initials: H
authors.lastname: Sievert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016009:Chi-Square Distribution; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008943:Mitral Valve / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018579:Patient Selection; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: MitraClip; inoperable; logistic EuroScore; mitral valve regurgitation; percutaneous mitral valve repair