Percutaneous mitral valve repair (PMVR) using the MitraClip System is feasible and
entails clinical improvement even in patients with high surgical risk and severe functional
mitral regurgitation (MR). The aim of this study was to assess survival rates and
clinical outcome of patients with severe, functional MR treated with optimal medical
therapy (OMT) compared with those who received MitraClip device. Sixty patients treated
with OMT were compared with a propensity-matched cohort of 60 patients who underwent
PMVR. Baseline demographics and echocardiographic variables were similar between the
2 groups. The mean age of patients was 75 years, and 67% were men. The median logistic
EuroSCORE and EuroSCORE II were 17% and 6%, respectively, because of the presence
of several co-morbidities. The mechanism of MR was functional in all cases with an
ischemic etiology in 52% of patients. Median left ventricle ejection fraction was
34%. All the patients were symptomatic for dyspnea with 63% and 12% in the New York
Heart Association class III and IV, respectively. In PMVR group, the procedure was
associated with safety and very low incidence of procedural complications with no
occurrence of procedural and inhospital mortality. After a median follow-up of 515 days
(248 to 828 days), patients treated with PMVR demonstrated overall survival, survival
freedom from cardiac death and survival free of readmission due to cardiac disease
curves higher than patients treated conservatively (log-rank test p = 0.007, p = 0.002,
and p = 0.04, respectively). In conclusion, PMVR offers a valid option for selected
patients with high surgical risk and severe, functional MR and entails better survival
outcomes compared with OMT.
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Article Info
Publication History
Published online: November 06, 2015
Accepted:
October 22,
2015
Received in revised form:
October 22,
2015
Received:
August 9,
2015
Footnotes
See page 276 for disclosure information.
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Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
