Long-term survival after MitraClip ® therapy in patients with severe mitral regurgitation and severe congestive heart failure: A comparison among survivals predicted by heart failure models

Abstract

In the overall patient cohort defined by 3+ to 4+ mitral valve regurgitation with New York Heart Association III and IV symptomatic heart failure, mortality following MC is consistent with that predicted by SHFM and MAGGIC for patients that are not at high risk. However, the subset of patients with severe heart failure defined by NTproBNP >10,000pg/ml had worse than predicted mortality and may not benefit from MC therapy, mainly due to a high 30-day mortality.

Mitraclip therapy in patients with functional mitral regurgitation and missing leaflet coaptation: is it still an exclusion criterion?

“…Our mortality data at long‐term follow‐up (28%) are consistent with those reported in previous single and multicentre studies (19–34%) …”

Impact of an interatrial shunt device on survival and heart failure hospitalization in patients with preserved ejection fraction

“…35 A similar approach has previously been applied to assess the impact of other interventions in HFrEF. 38 The MAGGIC score estimated Figure 2 Bar graphs represent baseline (pre-interatrial shunt device) peak exercise haemodynamic parameters in relation to subsequent heart failure hospitalization (HFH) events. PA, pulmonary artery; PCWP, pulmonary capillary wedge pressure.…”

Observed versus predicted mortality after MitraClip treatment in patients with symptomatic heart failure and significant functional mitral regurgitation

“…Presently, it is known that severe MR is an independent risk factor for mortality in patients with HF despite OMT . Therefore, assuming that SHFM and MAGGIC scores would have underestimated the predicted mortality reported in Figure , we can speculate that a benefit can be conferred by the MitraClip procedure in reducing the adverse effects of volume overload induced by FMR. On the contrary, 3C‐HF weighs the degree of functional mitral insufficiency in patients with HF.…”

“…Currently, there are limited data regarding observed and predicted mortality by the available HF scores after MitraClip treatment. Schau et al 6 already investigated short-term mortality following MitraClip treatment in patients with MR and moderate-to-severe symptomatic HF in comparison to mortality predicted by the SHFM and MAGGIC scores. First of all, our study provided a longer follow-up and, secondly, the use of the 3C-HF risk calculator allowed us to weight the impact of mitral disease.…”