A2028 JACC March 17, 2015 Volume 65, Issue 10S
Valvular Heart Disease Improvement in Quality of Life in Patients with Degenerative Mitral Regurgitation ST Prohibitive Surgical Risk Following Transcatheter Mitral Valve Repair with the Mitraclip System Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 3:45 p.m.-4:30 p.m. Session Title: Mitral Valve Disease Abstract Category: 40. Valvular Heart Disease: Clinical Presentation Number: 1227-360 Authors: Brijeshwar Singh Maini, O’Hara Haley, Aneesha Maini, Mubashir Mumtaz, Gregg Stone, PinnacleHealth Cardiovascular Institute, Harrisburg, PA, USA, Columbia University, New York, NY, USA Background: Improvement in quality of life in patients with degenerative mitral regurgitation at prohibitive surgical risk following transcatheter mitral valve repair with the MitraClip system.
Methods: MitraClip repair was performed in 42 prohibitive risk DMR patients with 4+ MR after a multi-disciplinary heart team deemed them to be ineligible for surgery. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was administered at baseline and one-month followup to assess QOL.
Results: Mean age was 78±9 years, and mean STS score was 12.2%. MitraClip deployment was successful in 41/42 patients (97.6%); 1 case was unsuccessful due to a very small left atrium. Two clips were deployed in 22 patients (52.3%). There were no vascular complications, strokes or procedural deaths. At 30 days, 2 patients died (4.7%), 1 due to respiratory failure at 48 hours and 1 due to a stroke at 3 weeks. At 1-month follow-up, 34 patients (80.9%) had Grade 1-2+ MR. QOL as assessed by the KCCQ in 39 patients was significantly improved (P<0.001) in 1-month survivors. Eight different quality domains were used for assessment of QOL. These included activity, edema, fatigue, shortness of breath, orthopnea, enjoyment of life, satisfaction at status quo health and activity limitation. There was a significant improvement in all domains assessed. Conclusion: Transcatheter mitral valve repair with the MitraClip in prohibitive surgical risk patients with DMR results in substantial improvement in QOL. Further studies are needed to examine whether these results are durable and associated with other improved clinical outcomes.