Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: Durability of the procedure and predictors of outcome

Abstract

Objective: Analyse 2-year outcomes after MitraClip therapy and identify predictors of outcome. Methods: Consecutive patients (n=74) undergoing MitraClip therapy were included in the MitraSWISS registry and followed prospectively. esults: A reduction of mitral regurgitation (M) to = mild was achieved in 32 (43%) patients and to moderate in 31 (42%) patients; 16/63 (25%) patients with initially successful treatment developed recurrent moderate to severe or severe M during the first year and only 1 patient did so during the second year. At 2 years, moderate or less M was more frequently present in patients with a transmitral mean gradient <3 mm Hg at baseline (73% vs 23%, p < 0.01) and in patients with a left atrial volume index (LAVI) <50 mL/m2 at baseline (86% vs 52%, p=0.03). More than mild M post MitraClip, N-terminal probrain natriuretic peptide =5000 ng/L at baseline, chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) were associated with reduced survival. Conclusions: A mean transmitral gradient <3 mm Hg at baseline, an LAVI <50 mL/m2, the absence of COPD and CKD, and reduction of M to less than moderate were associated with favourable outcome. Given a suitable anatomy, such patients may be excellent candidates for MitraClip therapy. Between 1 and 2 years follow-up, clinical and echocardiographic outcomes were stable, suggesting favourable, longterm durability of the device.