1. Transcatheter mitral repair according to the cause of mitral regurgitation: real-life data from the Spanish MitraClip registry
- Author
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Pablo Avanzas, German Armijo, Juan H. Alonso-Briales, Lara Ruiz Gómez, Pilar Jiménez-Quevedo, Armando Pérez de Prado, Covadonga Fernández-Golfín, Leire Andraka Ikazuriaga, Antonio Serra, José M. Hernández-García, Manuel Pan, Dabit Arzamendi, Chi Hion Li, Ana Belen Cid Alvarez, Ignacio J. Amat-Santos, Ana María Serrador Frutos, Felipe Fernández-Vázquez, Fernando Carrasco-Chinchilla, Alberto Berenguer Jofresa, Xavier Freixa, Rosa Ana Hernández-Antolín, Rafael Campos-Arjona, Luis Nombela-Franco, Víctor León, Ignacio Cruz-González, Rodrigo Estévez-Loureiro, María Soledad Alcasena Juango, Carmen Garrote Coloma, Xavier Millán, Miguel Romero, Isaac Pascual, José Luis Díez Gil, Laura Sanchis, Ramiro Trillo Nouche, Ander Regueiro, César Morís, and Tomás Benito González
- Subjects
Male ,medicine.medical_specialty ,Cardiac Catheterization ,Multivariate analysis ,Etiology ,Severe mitral regurgitation ,macromolecular substances ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Reparación de la válvula mitral transcatéter ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,MitraClip ,Prospective Studies ,Registries ,cardiovascular diseases ,Prospective cohort study ,Aged ,Aged, 80 and over ,Heart Valve Prosthesis Implantation ,Mitral regurgitation ,Ejection fraction ,business.industry ,Insuficiencia mitral grave ,Mitral Valve Insufficiency ,Stroke Volume ,General Medicine ,Middle Aged ,medicine.disease ,Etiología ,Treatment Outcome ,Heart failure ,Cardiology ,cardiovascular system ,Transcatheter mitral valve repair ,Mitral Valve ,Etiology, Etiología, Insuficiencia mitral grave, MitraClip, Reparación de la válvula mitral transcatéter, Severe mitral regurgitation, Transcatheter mitral valve repair ,Female ,business - Abstract
Introduction and objectives: Transcatheter mitral valve repair (TMVR) with MitraClip is a therapeutic option for high surgical risk patients with severe mitral regurgitation (MR). The main objective of this study was to analyze differences in outcomes in patients with severe MR according to the cause of MR. Methods: Observational, multicenter, and prospective study with consecutive patient inclusion. The primary endpoint was the combination of all-cause mortality and new readmissions due to heart failure after 1 year. We compared clinical and procedural characteristics and the event rate for each MR group. We performed a multivariate analysis to identify predictive variables for the primary endpoint. Results: A total of 558 patients were included: 364 (65.2%) with functional etiology, 111 (19.9%) degenerative and 83 (14.9%) mixed. The mean age was 72.8 +/- 11.1 years and 70.3% of the sample were men. There were 95 (17%) events in the overall sample. No significant differences were found in the 3 groups in the number of primary outcome events: 11 (11.3%) in degenerative MR, 71 (21.3%) in functional MR, and 13 (18.1%) in mixed MR (P=.101). Independent predictors were functional class (P=.029), previous surgical revascularization (P=.031), EuroSCORE II (P=.003), diabetes mellitus (P=.037), and left ventricular ejection fraction (P=.015). Conclusions: This study confirms the safety and efficacy of TMVR with MitraClip irrespective of MR etiology in real-life data and shows the main factors related to prognosis during the first year of follow up. (C) 2019 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
- Published
- 2020