Long‐term survival and preprocedural predictors of mortality in high surgical risk patients undergoing percutaneous mitral valve repair

Abstract

Percutaneous MVR using the MitraClip system has favorable long-term survival rates in high surgical risk patients. Preprocedural NYHA functional class III and IV, elevated log-NTproBNP levels and advanced age predict higher long-term cardiac mortality and should be considered during patient selection.

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%) …”

Previous malignancy is an independent predictor of follow‐up mortality after percutaneous treatment of mitral valve regurgitation by means of MitraClip

“…Finally, operators should not underestimate the importance of postprocedural echocardiographic findings and their possible association with outcomes. Although not emerging from our analysis, it has been already emphasized that procedural success; in particular, the persistence of MV regurgitation greater than grade II, and pre‐operative depressed LVEF%, may have a dismal association with follow‐up outcomes . Moreover, in our univariate comparison, higher mean transmitral gradients and smaller MV effective orifice area were present in those patients who died during follow‐up.…”

“…Similar findings have been proposed in the SENTINEL registry analysis where logistic Euro‐SCORE, left ventricular ejection fraction <30%, and acute procedural success were all independently associated with the risk of mortality or hospitalization at 1 year from MitraClip implantation . The German TRAMI registry and at least one other recent single‐center report have confirmed the importance of preprocedural functional class, baseline LVEF%, procedural success, and patient's age as predictors of follow‐up outcome …”

“…The association between a positive anamnesis for neoplastic disease and acute/follow‐up outcome of patients undergoing percutaneous MVR has never been investigated in the previous literature, and attention has been directed toward other predictors of outcomes . In a recent multicenter study, Capodanno et al.…”

Mortality after percutaneous edge-to-edge mitral valve repair: a contemporary review

“…Shortterm effectiveness and safety of this percutaneous device have already been proved in both high-and low-risk patient groups (10)(11)(12)(13)(14)(15)(16). Considering short-term mortality, we know that patients treated with the MC are not at a disadvantage (13,17,18). However, since the MC is still a relative novelty, long-term survival results remain largely unknown.…”