Predictors of clinical outcomes after edge-to-edge percutaneous mitral valve repair

Davide Capodanno, Marianna Adamo, Marco Barbanti, Cristina Giannini, Maria Luisa Laudisa, Stefano Cannata, Salvatore Curello, Sebastiano Immè, Diego Maffeo, Francesco Bedogni, Anna Sonia Petronio, Federica Ettori, Corrado Tamburino, Carmelo Grasso

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Abstract

Background There is limited information on the long-term outcomes and prognostic clinical predictors after edge-to-edge transcatheter mitral valve repair with the MitraClip system. Methods Consecutive patients with mitral regurgitation (MR) undergoing MitraClip therapy between October 2008 and November 2013 in 4 Italian centers were analyzed. The primary end point of interest was all-cause death. The secondary end point was the composite of all-cause death or rehospitalization for heart failure. Results A total of 304 patients were included, of which 79% had functional MR and 17% were in New York Heart Association functional class IV. Acute procedural success was obtained in 92% of cases, with no intraprocedural death. The cumulative incidences of all-cause death were 3.4%, 10.8%, and 18.6% at 30 days, 1 year, and 2 years, respectively. The corresponding incidences of the secondary end point were 4.4%, 22.0%, and 39.7%, respectively. In the Cox multivariate model, New York Heart Association functional class IV at baseline and ischemic MR etiology were found to significantly and independently predict both the primary and the secondary end point. A baseline, left ventricular end-systolic volume >110 mL was found to be an independent predictor of the secondary endpoint. Acute procedural success was independently associated with a lower risk of all-cause death and the combination of all-cause death or rehospitalization for heart failure at long-term follow-up. Conclusions In a cohort of patients undergoing MitraClip therapy, those presenting at baseline with ischemic functional etiology, severely dilated ventricles, or advanced heart failure and those undergoing unsuccessful procedures carried the worst prognosis.

Original languageEnglish
Pages (from-to)187-195
Number of pages9
JournalAmerican Heart Journal
Volume170
Issue number1
DOIs
Publication statusPublished - Jul 1 2015

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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    Capodanno, D., Adamo, M., Barbanti, M., Giannini, C., Laudisa, M. L., Cannata, S., Curello, S., Immè, S., Maffeo, D., Bedogni, F., Petronio, A. S., Ettori, F., Tamburino, C., & Grasso, C. (2015). Predictors of clinical outcomes after edge-to-edge percutaneous mitral valve repair. American Heart Journal, 170(1), 187-195. https://doi.org/10.1016/j.ahj.2015.04.010