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Impact of cardiac comorbidities on early and 1-year outcome after percutaneous mitral valve interventions: data from the German transcatheter mitral valve interventions (TRAMI) registry

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Abstract

Aims

The use of the MitraClip system has gained widespread acceptance for the treatment of patients with mitral regurgitation (MR) who are not suitable for the conventional surgery. This study sought to investigate the early and 1-year outcome after MitraClip therapy of patients with MR and cardiac comorbidities.

Methods and results

Outcomes through 12-month follow-up of patients (n = 528) who underwent MitraClip implantation were obtained from the German transcatheter mitral valve interventions (TRAMI) registry. The majority of these patients (n = 409, 77.5 %) also suffered from coronary artery disease (CAD). Patients with a dilated cardiomyopathy (DCM, n = 65, 12.3 %) or concomitant valvular aortic disease (AV, n = 54, 10.2 %) were less frequent. Although the prevalent pathogenesis was functional MR, patients with DCM had significantly more frequent a functional MR (96.9 %) compared to patients with CAD (74.9 %) or AV (62.5 %, p < 0.001). Technical success was achieved in 97.5 % of patients. Procedural echocardiograms demonstrated in the vast majority of patients a reduction from severe MR III to mild MR I with no difference between the groups (p = 0.83). The peri-procedural complication rate was very low. At 30-day and 12-month follow-up, the majority of patients were in NYHA functional class II or lower. The rate of death, stroke, and myocardial infarction (MACCE) was comparable in the three patient groups during 12-month follow-up (DCM 26.9 %, CAD 30.3 % and AV 27.5 %, p = 0.85).

Conclusions

The MitraClip implantation is feasible and safe even in high-risk patients with MR and cardiac comorbidities.

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Authors and Affiliations

  1. Hamburg University Cardiovascular Center, Wördemanns Weg 25-27, 22527, Hamburg, Germany

    Carsten Schwencke, Klaudija Bijuklic & Joachim Schofer

  2. Institute for Myocardial Infarction Research Foundation, Ludwigshafen, Germany

    Taoufik Ouarrak & Jochen Senges

  3. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany

    Edith Lubos

  4. HELIOS Albert-Schweizer-Klinik Northeim, Northeim, Germany

    Wolfgang Schillinger

  5. Heart Center, Georg-August-University Göttingen, Göttingen, Germany

    Wolfgang Schillinger

  6. Klinikum Westfalen, Dortmund, Germany

    Björn Plicht

  7. Cardiovascular Center Bethanien, Frankfurt, Germany

    Holger Eggebrecht

  8. Department of Cardiology, Heart Center, University Hospital Cologne, Cologne, Germany

    Stephan Baldus

  9. Department of Cardiology and Angiology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany

    Gerhard Schymik

  10. Department of Cardiology and Angiology, HELIOS Heart Center Siegburg, Siegburg, Germany

    Peter Boekstegers

  11. Department of Cardiology and Angiology, Bonifatius Hospital Lingen, Lingen, Germany

    Rainer Hoffmann

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  1. Carsten Schwencke
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  2. Klaudija Bijuklic
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  3. Taoufik Ouarrak
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  8. Stephan Baldus
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  11. Rainer Hoffmann
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Correspondence to Carsten Schwencke.

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The authors declare that they have no conflicts of interest.

Funding

The Institute for Myocardial Infarction Research Foundation, Ludwigshafen, Germany.

Ethical standards

All persons gave their informed consent prior to their inclusion in the study. The study was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

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Schwencke, C., Bijuklic, K., Ouarrak, T. et al. Impact of cardiac comorbidities on early and 1-year outcome after percutaneous mitral valve interventions: data from the German transcatheter mitral valve interventions (TRAMI) registry. Clin Res Cardiol 106, 249–258 (2017). https://doi.org/10.1007/s00392-016-1044-3

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