Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2017; 9(1): 39-46
Published online Jan 26, 2017. doi: 10.4330/wjc.v9.i1.39
One-year outcome of percutaneous mitral valve repair in patients with severe symptomatic mitral valve regurgitation
Michael Gotzmann, Isabell Sprenger, Aydan Ewers, Andreas Mügge, Leif Bösche
Michael Gotzmann, Department of Cardiology, Marien-Hospital Witten, Ruhr-University Bochum, 58452 Witten, Germany
Isabell Sprenger, Aydan Ewers, Andreas Mügge, Leif Bösche, Cardiology and Angiology, University-Hospital Bergmannsheil, 44789 Bochum, Germany
Author contributions: Gotzmann M was the guarantor and designed the study; Gotzmann M, Sprenger I, Ewers A and Bösche L participated in the acquisition, analysis, and interpretation of the data; Gotzmann M drafted the initial manuscript; Mügge A and Bösche L critically revised the article for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Ruhr-University Bochum Institutional Review Board.
Informed consent statement: All patients provided oral and written informed consent with respect to the intervention. However, due to the retrospective nature of the study, there was no written consent of patients prior to study enrolment. The study was approved by the Ruhr-University Bochum Institutional Review Board. All patient data were anonymized.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michael Gotzmann, MD, Associate Professor of Internal Medicine, Department of Cardiology, Marien-Hospital Witten, Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany. michael.gotzmann@ruhr-uni-bochum.de
Telephone: +49-2302-1733875 Fax: +49-2302-1731303
Received: July 24, 2016
Peer-review started: July 29, 2016
First decision: September 6, 2016
Revised: October 30, 2016
Accepted: November 21, 2016
Article in press: November 22, 2016
Published online: January 26, 2017
Processing time: 178 Days and 14.8 Hours
Abstract
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% vs after MitraClip® 13%; P < 0.001), and the NYHA functional classes improved (NYHA III/IV before MitraClip® 98% vs after MitraClip® 35%; P < 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; P = 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.

Keywords: Severe mitral regurgitation; Percutaneous mitral valve repair; MitraClip®; One-year outcome

Core tip: Percutaneous mitral valve repair with the MitraClip® device has positive effects on hemodynamics and symptoms. Despite the multiple comorbidities and extremely high operative risk of the study patients, mid-term outcomes after MitraClip® implantation are favorable. Elevated B-type natriuretic peptide (> 817 pg/mL) levels are indicative of poorer long-term survival.