title: Percutaneous Mitral Valve Repair With the MitraClip in Primary Compared With Secondary Mitral Valve Regurgitation Using the Mitral Valve Academic Research Consortium Criteria.
abstract: OBJECTIVE
  To compare early device success, procedural success, and 30-day safety endpoint according to the new Mitral Valve Academic Research Consortium criteria (MVARC) in severe primary and secondary mitral regurgitation (MR) patients.
  
  
  RESULTS
  A total of 210 patients were enrolled; 105 patients with primary MR were compared with 105 patients with secondary MR. All patients were highly symptomatic (New York Heart Association III/IV 79.0% vs 87.6%). Decision for MitraClip therapy was done by the heart team. Patients were on optimal medical heart failure therapy. Preprocedural MR grade was 3.4 ± 0.5 in secondary MR vs 3.7 ± 0.4 in primary MR (P<.001). Device success according to MVARC was high in both groups (93.3% in secondary MR vs 94.3% in primary MR), treated with 1.4 ± 0.6 vs 1.3 ± 0.5 MitraClips (P=.14). Reduction of New York Heart Association class from baseline to 30-day follow-up was 1.7 ± 1.1 in secondary MR vs 2.2 ± 1.2 in primary MR (P<.01). Rate of MVARC minor vascular complications was low. Thirty-day safety endpoint according to MVARC criteria was low in both groups (4.8% in secondary MR vs 5.7% in primary MR (P=non-significant).
  
  
  CONCLUSIONS
  Percutaneous mitral valve repair using the MitraClip device is safe and effective in patients with primary and secondary MR, with a high early device success rate and low 30-day safety endpoint according to the MVARC criteria.
authors.forename: Julia
authors.initials: J
authors.lastname: Seeger
authors.forename: Patrick
authors.initials: P
authors.lastname: Müller
authors.forename: Birgid
authors.initials: B
authors.lastname: Gonska
authors.forename: Dominik
authors.initials: D
authors.lastname: Scharnbeck
authors.forename: Sinisa
authors.initials: S
authors.lastname: Markovic
authors.forename: Daniel
authors.initials: D
authors.lastname: Walcher
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rottbauer
authors.affiliation: Department of Internal Medicine II, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany. jochen.woehrle@uniklinik-ulm.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Wöhrle
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011474:Prosthesis Design; D012955:Societies, Medical; D016896:Treatment Outcome