title: Impact of cardiac comorbidities on early and 1-year outcome after percutaneous mitral valve interventions: data from the German transcatheter mitral valve interventions (TRAMI) registry.
abstract: OBJECTIVE
  The use of the MitraClip system has gained widespread acceptance for the treatment of patients with mitral regurgitation (MR) who are not suitable for the conventional surgery. This study sought to investigate the early and 1-year outcome after MitraClip therapy of patients with MR and cardiac comorbidities.
  
  
  RESULTS
  Outcomes through 12-month follow-up of patients (n = 528) who underwent MitraClip implantation were obtained from the German transcatheter mitral valve interventions (TRAMI) registry. The majority of these patients (n = 409, 77.5 %) also suffered from coronary artery disease (CAD). Patients with a dilated cardiomyopathy (DCM, n = 65, 12.3 %) or concomitant valvular aortic disease (AV, n = 54, 10.2 %) were less frequent. Although the prevalent pathogenesis was functional MR, patients with DCM had significantly more frequent a functional MR (96.9 %) compared to patients with CAD (74.9 %) or AV (62.5 %, p < 0.001). Technical success was achieved in 97.5 % of patients. Procedural echocardiograms demonstrated in the vast majority of patients a reduction from severe MR III to mild MR I with no difference between the groups (p = 0.83). The peri-procedural complication rate was very low. At 30-day and 12-month follow-up, the majority of patients were in NYHA functional class II or lower. The rate of death, stroke, and myocardial infarction (MACCE) was comparable in the three patient groups during 12-month follow-up (DCM 26.9 %, CAD 30.3 % and AV 27.5 %, p = 0.85).
  
  
  CONCLUSIONS
  The MitraClip implantation is feasible and safe even in high-risk patients with MR and cardiac comorbidities.
authors.affiliation: Hamburg University Cardiovascular Center, Wördemanns Weg 25-27, 22527, Hamburg, Germany. schwencke@herz-hh.de.
authors.forename: Carsten
authors.initials: C
authors.lastname: Schwencke
authors.affiliation: Hamburg University Cardiovascular Center, Wördemanns Weg 25-27, 22527, Hamburg, Germany.
authors.forename: Klaudija
authors.initials: K
authors.lastname: Bijuklic
authors.affiliation: Institute for Myocardial Infarction Research Foundation, Ludwigshafen, Germany.
authors.forename: Taoufik
authors.initials: T
authors.lastname: Ouarrak
authors.affiliation: Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
authors.forename: Edith
authors.initials: E
authors.lastname: Lubos
authors.affiliation: HELIOS Albert-Schweizer-Klinik Northeim, Northeim, Germany.|Heart Center, Georg-August-University Göttingen, Göttingen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schillinger
authors.affiliation: Klinikum Westfalen, Dortmund, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Plicht
authors.affiliation: Cardiovascular Center Bethanien, Frankfurt, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Eggebrecht
authors.affiliation: Department of Cardiology, Heart Center, University Hospital Cologne, Cologne, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Baldus
authors.affiliation: Department of Cardiology and Angiology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schymik
authors.affiliation: Department of Cardiology and Angiology, HELIOS Heart Center Siegburg, Siegburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Boekstegers
authors.affiliation: Department of Cardiology and Angiology, Bonifatius Hospital Lingen, Lingen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Hoffmann
authors.affiliation: Institute for Myocardial Infarction Research Foundation, Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.affiliation: Hamburg University Cardiovascular Center, Wördemanns Weg 25-27, 22527, Hamburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000453:epidemiology*; D006328:Cardiac Catheterization / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D011184:Postoperative Period; D015995:Prevalence; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D012307:Risk Factors; D013997:Time Factors
keywords: Aortic valve disease; Coronary heart disease; Dilated cardiomyopathy; MitraClip; Mitral regurgitation