title: Initial experience of percutaneous treatment of mitral regurgitation with MitraClip® therapy in Spain.
abstract: OBJECTIVE
  Symptomatic mitral regurgitation has an unfavorable prognosis unless treated by surgery. However, the European registry of valvular heart disease reports that 49% of patients with this condition do not undergo surgery. Percutaneous treatment of mitral regurgitation with MitraClip® has been proved a safe, efficient adjunct to medical treatment in patients with this profile. The objective of the present study is to describe initial experience of MitraClip® therapy in Spain.
  
  
  METHODS
  Retrospective observational study including all patients treated between November 2011 and July 2013 at the 4 Spanish hospitals recording the highest numbers of implantations.
  
  
  RESULTS
  A total of 62 patients (77.4% men) were treated, mainly for restrictive functional mitral regurgitation (85.4%) of grade III (37%) or grade IV (63%), mean (standard deviation) ejection fraction 36% (14%), and New York Heart Association functional class III (37%) or IV (63%). Device implantation was successful in 98% of the patients. At 1 year, 81.2% had mitral regurgitation ≤ 2 and 90.9% were in New York Heart Association functional class ≤ II. One periprocedural death occurred (sepsis at 20 days post-implantation) and another 3 patients died during follow-up (mean, 9.1 months). Two patients needed a second implantation due to partial dehiscence of the first device and 2 others underwent heart transplantation.
  
  
  CONCLUSIONS
  In Spain, MitraClip® therapy has principally been aimed at patients with functional mitral regurgitation, significant systolic ventricular dysfunction, and high surgical risk. It is considered a safe alternative treatment, which can reduce mitral regurgitation and improve functional capacity.
authors.affiliation: Unidad del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Carrasco-Chinchilla
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Dabit
authors.initials: D
authors.lastname: Arzamendi
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Gimeno de Carlos
authors.affiliation: Unidad del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
authors.forename: Juan Horacio
authors.initials: JH
authors.lastname: Alonso-Briales
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Chi-Hion
authors.initials: CH
authors.lastname: Li
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Mesa
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Roman
authors.initials: R
authors.lastname: Arnold
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Serrador Frutos
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Eulalia
authors.initials: E
authors.lastname: Roig
authors.affiliation: Unidad del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Rodríguez-Bailón
authors.affiliation: Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: de la Fuente Galán
authors.affiliation: Unidad del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Electronic address: jmhg@secardiologia.es.
authors.forename: José María
authors.initials: JM
authors.lastname: Hernández
authors.affiliation: Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Serra
authors.affiliation: Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo
mesh_terms: D000368:Aged; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
keywords: Endovascular technique; Heart failure; Insuficiencia cardiaca; Insuficiencia mitral valvular; Mitral regurgitation; Técnica endovascular