One-year outcome of percutaneous mitral valve repair in patients with severe symptomatic mitral valve regurgitation

AIM: 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% vs after MitraClip(®) 13%; P < 0.001), and the NYHA functional classes improved (NYHA III/IV before MitraClip(®) 98% vs after 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). CONCLUSION: 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.