title: Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome.
abstract: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome.
  
  
  
  Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively.
  
  
  
  A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m(2) at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival.
  
  
  
  A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m(2), the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.
authors.affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Toggweiler
authors.affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland ; University Hospital Zurich , Zurich , Switzerland.
authors.forename: Michel
authors.initials: M
authors.lastname: Zuber
authors.affiliation: Fondazione Cardiocentro Ticino , Lugano , Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sürder
authors.affiliation: University Hospital Zurich , Zurich , Switzerland ; HeartClinic Hirslanden , Zurich , Switzerland.
authors.forename: Patric
authors.initials: P
authors.lastname: Biaggi
authors.affiliation: University Hospital Zurich , Zurich , Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Gstrein
authors.affiliation: Fondazione Cardiocentro Ticino , Lugano , Switzerland.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Moccetti
authors.affiliation: Fondazione Cardiocentro Ticino , Lugano , Switzerland.
authors.forename: Elena
authors.initials: E
authors.lastname: Pasotti
authors.affiliation: University Hospital Zurich , Zurich , Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.affiliation: Fondazione Cardiocentro Ticino , Lugano , Switzerland.
authors.forename: Francesco
authors.initials: F
authors.lastname: Faletra
authors.affiliation: Fondazione Cardiocentro Ticino , Lugano , Switzerland.
authors.forename: Iveta
authors.initials: I
authors.lastname: Petrova-Slater
authors.affiliation: University Hospital Zurich , Zurich , Switzerland ; HeartClinic Hirslanden , Zurich , Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Grünenfelder
authors.affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland.
authors.forename: Peiman
authors.initials: P
authors.lastname: Jamshidi
authors.affiliation: University Hospital Zurich , Zurich , Switzerland ; HeartClinic Hirslanden , Zurich , Switzerland.
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
authors.affiliation: Fondazione Cardiocentro Ticino , Lugano , Switzerland.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pedrazzini
authors.affiliation: University Hospital Zurich , Zurich , Switzerland.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.affiliation: Cantonal Hospital Lucerne , Lucerne , Switzerland ; University Hospital Zurich , Zurich , Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Erne
keywords: INTERVENTIONAL CARDIOLOGY; VALVULAR DISEASE