One-year outcome of percutaneous mitral valve repair in patients with severe symptomatic mitral valve regurgitation.

Aim: To investigate one-year outcomes after percutaneous mitral valve repair with MitraClip in patients with severe mitral regurgitation (MR). METHODS Our study investigated consecutive patients with symptomatic severe MR who underwent MitraClip implantation at the University Hospital Bergmannsheil from 2012 to 2014. The primary study end-point was all-cause mortality. Secondary end-points were degree of MR and functional status after percutaneous mitral valve repair.

Results: The study population consisted of 46 consecutive patients (mean logistic EuroSCORE 32% ± 21%). The degree of MR decreased significantly (severe MR before MitraClip 100% after MitraClip 13%; < 0.001), and the NYHA functional classes improved (NYHA III/IV before MitraClip 98% after MitraClip 35%; < 0.001). The mortality rates 30 d and one year after percutaneous mitral valve repair were 4.3% and 19.5%, respectively. During the follow-up of 473 ± 274 d, 11 patients died (90% due to cardiovascular death). A pre-procedural plasma B-type natriuretic peptide level > 817 pg/mL was associated with all-cause mortality (hazard ratio, 6.074; 95%CI: 1.257-29.239; = 0.012).

Conclusion: Percutaneous mitral valve repair with MitraClip has positive effects on hemodynamics and symptoms. Despite the study patients' multiple comorbidities and extremely high operative risk, one-year outcomes after MitraClip are favorable. Elevated B-type natriuretic peptide levels indicate poorer mid-term survival.