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- Title
212 MIDTERM OUTCOMES (OVER THREE YEARS) OF PERCUTANEOUS MITRAL REPAIR IN THE REAL WORLD: A SINGLE-CENTRE EXPERIENCE.
- Authors
Buzzatti, N.; Denti, P.; Schiavi, D.; Taramasso, M.; De Bonis, M.; Di Giannuario, G.; La Canna, G.; Alfieri, O.
- Abstract
Objectives: To assess midterm outcomes of MitraClip therapy in a real-world setting.Methods: We analysed the outcomes of 78 patients submitted to MitraClip at our Institution between October 2008 and April 2011. Functional (FMR: n = 54, 69.2%) and degenerative (DMR: n = 24, 30.8%) mitral repair groups were analysed separately.Results: Preoperative data included mean age 69 and 78 years, median STS mortality 4.7 and 6.9, mean ejection fraction (EF) 28% and 60% for FMR and DMR, respectively. Procedural mortality was 0%, procedural success was 90.7% in FMR and 83.3% in DMR patients. Actuarial overall survival was 68% at 50 months in FMR and 65% at 40 months in DMR patients. Actuarial freedom from cardiac death was 80.3% at 50 months and 86.8% at 40 months, respectively. Cardiac mortality was associated with preoperative larger ventricles (end diastolic diameter P = 0.0008) and post-procedural MR >1 (P = 0.004) in FMR group and with post-procedural MR >2 (P = 0.0006) in DMR group. It was not associated with late recurrent MR >2 in either group (P > 0.05). Freedom from recurrent MR > 2 was 76% at 50 months in FMR and 69% at 36 months in DMR group (P = 0.1). Post-procedural residual 2+ MR was not associated with follow-up MR >2 recurrence. At last follow-up (median 43.5 months), 91% of surviving patients were in NYHA I–II in both groups.Conclusion: In the common practice, MitraClip patients had a high-risk profile and a significant overall mid-term mortality, also due to extracardiac comorbidities. Post-procedural residual MR was associated with increased cardiac mortality. Although not significant, MR recurrence was lower in FMR compared to DMR patients, with persistent symptom benefits in most patients.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2014, Vol 19, Issue suppl_1, pS63
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivu276.212