One-year outcome of percutaneous mitral valve repair in patients with severe symptomatic mitral valve regurgitation.
OBJECTIVE
To investigate one-year outcomes after percutaneous mitral valve repair with MitraClip®in patients with severe mitral regurgitation (MR). METHODS Our study investigated consecutive patients with symptomatic severe MR who underwent MitraClip®implantation at the University Hospital Bergmannsheil from 2012 to 2014. The primary study end-point was all-cause mortality. Secondary end-points were degree of MR and functional status after percutaneous mitral valve repair.


RESULTS
The study population consisted of 46 consecutive patients (mean logistic EuroSCORE 32% ± 21%). The degree of MR decreased significantly (severe MR before MitraClip®100%vsafter MitraClip®13%;P< 0.001), and the NYHA functional classes improved (NYHA III/IV before MitraClip®98%vsafter MitraClip®35%;P< 0.001). The mortality rates 30 d and one year after percutaneous mitral valve repair were 4.3% and 19.5%, respectively. During the follow-up of 473 ± 274 d, 11 patients died (90% due to cardiovascular death). A pre-procedural plasma B-type natriuretic peptide level > 817 pg/mL was associated with all-cause mortality (hazard ratio, 6.074; 95%CI: 1.257-29.239;P= 0.012).


CONCLUSIONS
Percutaneous mitral valve repair with MitraClip®has positive effects on hemodynamics and symptoms. Despite the study patients' multiple comorbidities and extremely high operative risk, one-year outcomes after MitraClip®are favorable. Elevated B-type natriuretic peptide levels indicate poorer mid-term survival.
Michael Gotzmann, Department of Cardiology, Marien-Hospital Witten, Ruhr-University Bochum, 58452 Witten, Germany.
Michael
M
Gotzmann
Michael Gotzmann, Department of Cardiology, Marien-Hospital Witten, Ruhr-University Bochum, 58452 Witten, Germany.
Isabell
I
Sprenger
Michael Gotzmann, Department of Cardiology, Marien-Hospital Witten, Ruhr-University Bochum, 58452 Witten, Germany.
Aydan
A
Ewers
Michael Gotzmann, Department of Cardiology, Marien-Hospital Witten, Ruhr-University Bochum, 58452 Witten, Germany.
Andreas
A
Mügge
Michael Gotzmann, Department of Cardiology, Marien-Hospital Witten, Ruhr-University Bochum, 58452 Witten, Germany.
Leif
L
Bösche
MitraClip®; One-year outcome; Percutaneous mitral valve repair; Severe mitral regurgitation