Residual mitral valve regurgitation after percutaneous mitral valve repair with the mitraclip® system is a risk factor for adverse one‐year outcome

Abstract

MitraClip® is a valid tool with favorable outcomes in high-risk patients. The degree of residual MR seems to impact on follow-up composite endpoint outcome. An optimal correction of MR after MitraClip placement could be advocated to optimize the benefits of the procedure and minimize the risk of adverse outcomes.

Comparison of Outcomes of Percutaneous MitraClip Versus Surgical Repair or Replacement for Degenerative Mitral Regurgitation in Octogenarians

“…6,8,12,17,18 We believe this is also true for octogenarians, although in our series acute persistence and follow-up recurrence of MR >2þ were not significantly associated with reduced survival rate, likely because of small numbers and short follow-up.…”

Effect of advanced chronic kidney disease in clinical and echocardiographic outcomes of patients treated with MitraClip system

“…A handful of publications have focused on predictors of outcome following MitraClip [11][12][13][14][15][16]. Regarding procedural issues, both the inability to place a clip and the degree of residual MR left have been linked to a worse outcome [11,14,15]. Likewise, the inability of reduce the MR degree to ≤2+ has been associated with readmissions due to heart failure and with an impaired survival in a cohort of patients with degenerative MR [29].…”

“…These findings may be related to procedural, echocardiographic or patient characteristics. A handful of publications have focused on predictors of outcome following MitraClip [11][12][13][14][15][16]. Regarding procedural issues, both the inability to place a clip and the degree of residual MR left have been linked to a worse outcome [11,14,15].…”

“…However, in spite of this documented benefit, there is still a relevant proportion of patients experiencing adverse events in the follow-up. Likewise, few studies have focused on predictors of clinical adverse events after the MitraClip implantation [11][12][13][14][15][16]. Chronic kidney disease (CKD) has been shown to impact negatively the prognosis of patients diagnosed with heart failure, coronary artery or valvular heart disease, and in those undergoing cardiac interventions [17].…”

The MitraClip Experience and Future Percutaneous Mitral Valve Therapies

“…Observational data suggests the degree of residual MR after MitraClip implantation impacts independently and negatively on follow-up survival and adverse events [16]. However, despite incomplete freedom from MR in the MitraClip group of EVEREST II, both percutaneous and surgical groups experienced reductions in the degree of MR and improvements in LV dimensions.…”