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Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome

OBJECTIVE: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome. METHODS: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively. RESULTS: A reduction of mitral regurgitation (MR) to ≤ mild was achiev...

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Autores principales: Toggweiler, Stefan, Zuber, Michel, Sürder, Daniel, Biaggi, Patric, Gstrein, Christine, Moccetti, Tiziano, Pasotti, Elena, Gaemperli, Oliver, Faletra, Francesco, Petrova-Slater, Iveta, Grünenfelder, Jürg, Jamshidi, Peiman, Corti, Roberto, Pedrazzini, Giovanni, Lüscher, Thomas F, Erne, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195933/
https://www.ncbi.nlm.nih.gov/pubmed/25332799
http://dx.doi.org/10.1136/openhrt-2014-000056
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author Toggweiler, Stefan
Zuber, Michel
Sürder, Daniel
Biaggi, Patric
Gstrein, Christine
Moccetti, Tiziano
Pasotti, Elena
Gaemperli, Oliver
Faletra, Francesco
Petrova-Slater, Iveta
Grünenfelder, Jürg
Jamshidi, Peiman
Corti, Roberto
Pedrazzini, Giovanni
Lüscher, Thomas F
Erne, Paul
author_facet Toggweiler, Stefan
Zuber, Michel
Sürder, Daniel
Biaggi, Patric
Gstrein, Christine
Moccetti, Tiziano
Pasotti, Elena
Gaemperli, Oliver
Faletra, Francesco
Petrova-Slater, Iveta
Grünenfelder, Jürg
Jamshidi, Peiman
Corti, Roberto
Pedrazzini, Giovanni
Lüscher, Thomas F
Erne, Paul
author_sort Toggweiler, Stefan
collection PubMed
description OBJECTIVE: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome. METHODS: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively. RESULTS: A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m(2) at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival. CONCLUSIONS: A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m(2), the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device.
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spelling pubmed-41959332014-10-20 Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome Toggweiler, Stefan Zuber, Michel Sürder, Daniel Biaggi, Patric Gstrein, Christine Moccetti, Tiziano Pasotti, Elena Gaemperli, Oliver Faletra, Francesco Petrova-Slater, Iveta Grünenfelder, Jürg Jamshidi, Peiman Corti, Roberto Pedrazzini, Giovanni Lüscher, Thomas F Erne, Paul Open Heart Valvular Heart Disease OBJECTIVE: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome. METHODS: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively. RESULTS: A reduction of mitral regurgitation (MR) to ≤ mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe MR during the first year and only 1 patient did so during the second year. At 2 years, moderate or less MR was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m(2) at baseline (86% vs 52%, p=0.03). More than mild MR post MitraClip, N-terminal probrain natriuretic peptide ≥5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival. CONCLUSIONS: A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m(2), the absence of COPD and CKD, and reduction of MR to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, long-term durability of the device. BMJ Publishing Group 2014-04-08 /pmc/articles/PMC4195933/ /pubmed/25332799 http://dx.doi.org/10.1136/openhrt-2014-000056 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Valvular Heart Disease
Toggweiler, Stefan
Zuber, Michel
Sürder, Daniel
Biaggi, Patric
Gstrein, Christine
Moccetti, Tiziano
Pasotti, Elena
Gaemperli, Oliver
Faletra, Francesco
Petrova-Slater, Iveta
Grünenfelder, Jürg
Jamshidi, Peiman
Corti, Roberto
Pedrazzini, Giovanni
Lüscher, Thomas F
Erne, Paul
Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome
title Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome
title_full Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome
title_fullStr Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome
title_full_unstemmed Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome
title_short Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome
title_sort two-year outcomes after percutaneous mitral valve repair with the mitraclip system: durability of the procedure and predictors of outcome
topic Valvular Heart Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195933/
https://www.ncbi.nlm.nih.gov/pubmed/25332799
http://dx.doi.org/10.1136/openhrt-2014-000056
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