Impacto de la etiología de la regurgitación mitral en la mortalidad tardía de pacientes tratados con MitraClip®

Introduction

Mitral regurgitation is the second most common cause of valvular heart disease, and even though it involves so bad prognosis, almost a half of patients are rejected from surgical treatment. For this cohort of patients, it has treated with MitraClip^® with promising outcomes in both functional and degenerative etiology of mitral regurgitation.

Material and methods

Retrosprective observational study about features and outcomes of 72 patients underwent MitraClip^® implantation from November 2011 to October 2016.

Results

Mitral regurgitation etiology was functional (61.1%), degenerative (26.4%) or mixed (12.5%). The functional etiology was associated with lower age (67.9 ± 8.74 vs 74.6 ± 13.06 years old, P = .21) and lower left ventricular ejection fraction (34 ± 8.5% vs 57 ± 15%; P < .001). The median EuroSCORE-II was 3.84 (Q1-Q3 quartile: 2.21-8.10). There was no differences about the number of clips used (1.55 ± 0.68 functional and 1.64 ± 0.55 degenerative, P = .53) or the number of days in hospitalary admission after intervention (3.36 functional vs 3.7 degenerative; p = .56). Regurgitation reduction was partial (more than grade 2) in 4.5% of functional etiology and 14.3% of degenerative etiology (P = .145). No cases of in-hospital mortality or during the first month after discharge were reported. During an average follow up of 24 months it was reported 9 deaths (20.45%) in functional etiology and 2 deaths (7.14%) in degenerative/mixed etiology (P = .13).

Conclusion

MitraClip® treatment is safe and effective in patients with both functional and degenerative etiology of mitral regugitation, even though the last one seems to be associated with a lower late mortality rate.