Percutaneous mitral valve repair in a high-risk Australian series.
BACKGROUND
The prognosis for patients with symptomatic, severe mitral regurgitation (MR) who have comorbidities precluding mitral valve surgery is poor. Treatment of MR using a percutaneous edge-to-edge technique may improve survival, quality of life and reduce hospitalisations. To date, there are few studies reporting outcomes after percutaneous mitral valve repair in high-risk patients and none reported from Australia.


METHODS
The first 25 patients undergoing percutaneous mitral valve repair using the MitraClip in our Institution had follow-up to six months. These patients had severe, symptomatic MR and were deemed too high-risk for mitral valve surgery by a multidisciplinary heart team, including an interventional cardiologist and cardiothoracic surgeon.


RESULTS
There were no peri-procedural deaths; the only peri-procedural morbidity was blood transfusion in three patients. Three patients had died at six months and there were six readmissions to hospital. There was a significant improvement in heart failure symptoms, 6-minute walk test and quality of life at six months. There was a significant improvement in the proportion of patients with MR ≤2+, but no significant change in other echocardiographic parameters.


CONCLUSIONS
Percutaneous mitral valve repair is safe in patients at high-risk for surgery, and improves symptoms and quality of life.
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
J J B
JJ
Edelman
Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia.
P
P
Dias
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia; Notre Dame Medical School, Fremantle, Western Australia.
J
J
Passage
Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia. Electronic address: Eric.Yamen@health.wa.gov.au.
E
E
Yamen
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D006328:Cardiac Catheterization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000401:mortality* / Q000601:surgery*; D011788:Quality of Life; D012307:Risk Factors
Aged; Comorbidity; Heart valve prosthesis; Mitraclip; Mitral regurgitation