ECHOCARDIOGRAPHIC PREDICTORS OF RESIDUAL MR ≥ 2+ AND CLINICAL OUTCOMES ONE YEAR AFTER MITRACLIP IMPLANTATION

The extent of residual mitral regurgitation (MR) (1+ vs ≥ 2+) has a notable impact on the outcome of MitraClip (MC) repair of significant functional MR.

The aim of the study was to analyze the one–year results in our series of patients with functional MR treated with MC.

Between 2020 and 2022, 58 consecutive patients underwent percutaneous mitral valve repair with MC technology. All patients had moderate–severe MR on a functional basis.

At one year 10 patients died (mortality 17.2%). The remaining 48 patients had complete follow–up for up to one year and were included in the statistical analysis: The incidence of new hospitalizations was 8.3%; The incidence of grade 1+ and ≥ 2+ MR was 54.1% (26) and 45.9% (22), respectively; In patients with MR ≥ 2+ the clinical and instrumental outcomes were worse than in patients with MR 1+; Posterior leaflet height and extent of immediate postprocedural MR were independent predictors of MR ≥ 2+. In multivariable analysis, preprocedural posterior leaflet height (PLH) (OR 0.16, p = 0.02) and immediate postprocedural MR degree (IPOMR) (OR 12.4, p = 0.03) were predictive; preprocedural Ejection Fraction (EF) was almost significant (OR 0.87, p = 0.08) (Figure 1).

Percutaneous repair with MC of moderate/severe functional MR has favorable one–year outcomes in terms of mortality and rehospitalizations. The best results are obtained in cases with residual MR 1+. Echocardiographic parameters are independent predictors of residual MR ≥ 2+.