In:
Cardiovascular Therapeutics, Wiley, Vol. 32, No. 2 ( 2014-04), p. 66-73
Abstract:
Edge‐to‐edge repair of mitral regurgitation ( MR ) with the M itra C lip ® ( MC ) system is increasingly applied in advanced heart failure. Our objective was to compare outcomes in patients with mild‐to‐moderate and severe systolic heart failure. Methods and results Between F ebruary 2010 and J uly 2012, 121 patients with MR of at least grade 3+ and a mean E uro SCORE II of 10.6% underwent MC implantation. Thirty‐nine had a left ventricular ejection fraction ( LVEF ) of ≤30% (group A ) and 82 of 〉 30% (group B). Procedural success was comparable in both groups (100% vs. 95.2%) with multiple ( 〉 2) clip implantation in 34% and 25% of patients, respectively. At 12 months, absolute reduction in MR grade (2.3 vs. 2.2) and relative reduction in mitral valve orifice area (48% vs. 42%) were also comparable. N ew Y ork H eart A ssociation class had improved independent from baseline LVEF ( P 〈 0.001). In‐hospital mortality was low in both groups (2.6% vs. 2.4%), but there was a strong trend for higher 12‐month mortality in group A (34% vs. 18%, P = 0.05) with no significant difference in the overall rate of major adverse cerebrovascular and cardiac events (36.8% vs. 28.9%, P = 0.38). On multivariate analysis, MR grade after repair was the strongest predictor of mortality ( OR 2.121, 95% CI 1.095–4.109), whereas systolic impairment was no independent predictor. Conclusions Percutaneous mitral valve repair led to comparable symptomatic improvement in patients with mild‐to‐moderately or severely reduced LV function. LV ‐ EF 〈 30% was not an independent predictor of short‐term mortality, which was mainly governed by residual MR after repair.
Type of Medium:
Online Resource
ISSN:
1755-5914
,
1755-5922
DOI:
10.1111/cdr.2014.32.issue-2
DOI:
10.1111/1755-5922.12058
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2417088-4
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