title: Long-Term Outcomes After MitraClip Implantation According to the Presence or Absence of EVEREST Inclusion Criteria.
abstract: Numerous patients are treated with the MitraClip, although they do not fulfill the stringent inclusion criteria of the Endovascular Valve Edge-to-Edge Repair Study (EVEREST) trials. The outcome of those patients is not well known. Therefore, we compared the long-term outcome after MitraClip treatment between patients who matched (group 1) and did not match (group 2) the EVEREST criteria. One hundred thirty-four consecutive patients were treated from September 2009 to July 2012: 59 patients (44%) in group 1 versus 75 patients (56%) in group 2. Investigated end points were acute procedural success (for group 1 vs 2: 97% vs 95%; p = 0.694), all-cause mortality (28% vs 27%; p = 0.656), reintervention (RI) rate (11% vs 37%; p = 0.010), and improvement in mitral regurgitation (MR) (-1.3 ± 1 vs -1.5 ± 1, p = 0.221) and in New York Heart Association functional class (-0.7 ± 1 vs -0.9 ± 0.8, p = 0.253) during the follow-up of 33 months (27.9 to 38.3). The morphologic extent of a flail leaflet was an independent predictor for RI. In conclusion, although the overall outcome was comparable between both groups, recurrent symptomatic MR with need for RI was higher in group 2, mainly because of complex valve pathologies: especially flail width >15 mm and gap ≥10 mm. Improvements in the interventional strategy are warranted for reducing the need for RI in patients with primary MR.
authors.affiliation: Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. Electronic address: hasema.lesevic@gmail.com.
authors.forename: Hasema
authors.initials: H
authors.lastname: Lesevic
authors.affiliation: Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Karl
authors.affiliation: Department of Cardiology, Campus Groβhadern, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Braun
authors.affiliation: Department of Cardiology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Barthel
authors.affiliation: Department of Cardiology, Campus Groβhadern, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Orban
authors.affiliation: Department of Cardiology, Schön Klinik Starnberger See, Berg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Pache
authors.affiliation: Department of Radiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hadamitzky
authors.affiliation: Department of Cardiology, Campus Groβhadern, Ludwig-Maximilians-Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.affiliation: Else Kröner-Fresenius-Center for Nutritional Medicine, Technische Universität München, Munich, Germany.
authors.forename: Lynne
authors.initials: L
authors.lastname: Stecher
authors.affiliation: Department of Cardiology, Campus Groβhadern, Ludwig-Maximilians-Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Massberg
authors.affiliation: Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Ilka
authors.initials: I
authors.lastname: Ott
authors.affiliation: Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.affiliation: Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.affiliation: Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Sonne
authors.affiliation: Department of Cardiology, Campus Groβhadern, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Hausleiter
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000473:pathology*; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000628:therapy*; D063868:Patient Outcome Assessment; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D019233:Retreatment / Q000706:statistics & numerical data