Percutaneous mitral valve repair with the MitraClip system in the elderly: One-year outcomes from the GRASP registry

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• 作者：Salvatore Scandura¹ ; Piera Capranzano ; ¹ ; ^{pcapranzano@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Anna Caggegi¹ ; Carmelo Grasso¹ ; Giuseppe Ronsivalle¹ ; Sarah Mangiafico¹ ; Yohei Ohno¹ ; Guilherme F. Attizzani¹ ; Stefano Cannata¹ ; Sandra Giaquinta¹ ; Silvia Farruggio¹ ; Margherita Ministeri¹ ; Fabio Dipasqua¹ ; Anna M. Pistritto¹ ; Sebastiano Immè ; ¹ ; Davide Capodanno¹ ; Maria Elena Di Salvo¹ ; Corrado Tamburino¹
• 关键词：Mitral valve ; MitraClip ; Elderly
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 December 2016
• 年：2016
• 卷：224
• 期：Complete
• 页码：440-446
• 全文大小：571 K

文摘

Although mitral regurgitation (MR) affects a relevant and increasing number of elderly, an optimal management of this high-risk population is challenging.

Methods and results

The aim of this prospective, observational study was to compare one-year outcomes of MitraClip therapy in high surgical risk patients with moderate-to-severe or severe MR between patients aged < 75 versus ≥ 75 years. A total of 180 patients were included: 92 were < 75 years and 88 were ≥ 75 years old. At one-year follow-up the primary efficacy endpoint (composite of death, surgery for mitral valve dysfunction and grade 3 + or 4 + MR) occurred in 41 patients (24.5%), with similar rates between those aged < 75 years (23.9%) and those ≥ 75 years (25.2%), p = 0.912. A total of 21 (12.2%) deaths were observed within 1 year after the MitraClip procedure, without significant differences in cumulative mortality rates between elderly and younger patients (10.8% vs. 13.3%, respectively, p = 0.574). Compared with baseline, the significant reduction in MR severity achieved after the procedure was sustained at one-year follow-up, in both elderly and younger patients and a significant improvement in NYHA functional class was observed in both groups. A total of 18 (10.0%) patients experienced a re-hospitalization for acute heart failure within one-year after the MitraClip procedure, with no significant differences between elderly and younger. At one-year follow-up both elderly and younger patients showed significant reductions in left ventricular volumes, with changes of similar extent between the two subgroups.

Conclusions

MitraClip therapy can be considered a viable option also among subsets with more advanced age.