The MitraClip Asia-Pacific registry: Differences in outcomes between functional and degenerative mitral regurgitation.
OBJECTIVE
The objective of this study is to describe and compare the use of the MitraClip therapy in mitral regurgitation (MR) patients with degenerative MR (DMR) and functional MR (FMR).


BACKGROUND
Percutaneous edge-to-edge repair of severe MR using the MitraClip device is approved for use in the USA for high risk DMR while European guidelines include its use in FMR patients as well.


METHODS
The MitraClip in the Asia-Pacific Registry (MARS) is a multicenter retrospective registry, involving eight sites in five Asia-Pacific countries. Clinical and echocardiographic characteristics, procedural outcomes and 1-month outcomes [death and major adverse events (MAE)] were compared between FMR and DMR patients treated with the MitraClip.


RESULTS
A total of 163 patients were included from 2011 to 2014. The acute procedural success rates for FMR (95.5%, n = 84) and DMR (92%, n = 69) were similar (P = 0.515). 45% of FMR had ≥2 clips inserted compared to 60% of those with DMR (P = 0.064).The 30-day mortality rate for FMR and DMR was similar at 4.5% and 6.7% respectively (P = 0.555). The 30-day MAE rate was 9.2% for FMR and 14.7% for DMR (P = 0.281). Both FMR and DMR patients had significant improvements in the severity of MR and NYHA class after 30 days. There was a significantly greater reduction in left ventricular end-diastolic diameter (P = 0.002) and end systolic diameter (P = 0.017) in DMR than in FMR.


CONCLUSIONS
The MitraClip therapy is a safe and efficacious treatment option for both FMR and DMR. Although, there is a significantly greater reduction in LV volumes in DMR, patients in both groups report clinical benefit with improvement in functional class. © 2015 Wiley Periodicals, Inc.
Department of Cardiology, National University Heart Centre, Singapore.
Edgar
E
Tay
Department of Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia.
Nasir
N
Muda
Department of Cardiology, National Heart Centre Singapore, Singapore.
Jonathan
J
Yap
Department of Cardiology, St Vincent's Hospital, Sydney, Australia.
David W M
DW
Muller
Medistra Hospital, Jakarta, Indonesia.
Teguh
T
Santoso
Department of Cardiology, Prince Charles Hospital, Brisbane, Australia.
Darren L
DL
Walters
Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, People's Republic of China.
Xianbao
X
Liu
Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia.
Eric
E
Yamen
Department of Cardiothoracic Surgery, St Vincent's Hospital, Sydney, Australia.
Paul
P
Jansz
Department of Cardiology, National University Heart Centre, Singapore.
James
J
Yip
Department of Cardiology, Institut Jantung Negara, Kuala Lumpur, Malaysia.
Robaayah
R
Zambahari
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Australia.
Jurgen
J
Passage
Department of Cardiology, National Heart Centre Singapore, Singapore.
Zee Pin
ZP
Ding
Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, People's Republic of China.
Jian'an
J
Wang
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Australia.
Gregory
G
Scalia
Department of Cardiology, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
Amiliana M
AM
Soesanto
Department of Cardiology, National Heart Centre Singapore, Singapore.|Duke-NUS Graduate Medical School, Singapore.
Khung Keong
KK
Yeo
D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D001315:Australia; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D020127:Recovery of Function; D012042:Registries; D012189:Retrospective Studies; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
MitraClip; mitral regurgitation