The MitraClip Asia‐Pacific registry: Differences in outcomes between functional and degenerative mitral regurgitation

Abstract

The MitraClip therapy is a safe and efficacious treatment option for both FMR and DMR. Although, there is a significantly greater reduction in LV volumes in DMR, patients in both groups report clinical benefit with improvement in functional class. © 2015 Wiley Periodicals, Inc.

Predictors of left ventricular reverse remodeling after percutaneous therapy for mitral regurgitation with the MitraClip system

“…One could assume that reduction of the regurgitation in primary (degenerative) MR as the genuine (valvular) pathology should have a greater effect on LVRR than in FMR. This hypothesis has been supported by the Asia‐Pacific registry, where DMR cohort showed a significantly greater reduction in left ventricular end‐diastolic diameter after MC procedure compared to FMR cohort. In our study, LVRR was not different between DMR and FMR subgroups.…”

“…Despite comparable postprocedural results in both etiologies and despite comparable rates of recurrent MR to those published in the literature, recurrent/residual MR up to 12 months follow‐up was more frequent in the DMR group than in the FMR group in our study (24.5 vs. 9.0%). This is surprising, particularly since recurrence of MR is a main concern of FMR due to progressive LV dysfunction . In a recent meta‐analysis of 2,615 patients treated with the MC, the reported percentage of patients with MR grade ≤2 at 1‐year follow‐up was comparable between the two cohorts (58 vs. 54%).…”

Percutaneous Edge-to-Edge Mitral Valve Repair

“…MARS data showed that, for FMR and DMR, the acute procedural success (95.5% vs. 92%, respectively, p=0.515), 30-day mortality (4.5% vs. 6.7%, respectively, p=0.555) and functional improvement to NYHA class 1 and 2 at 30 days (78.2% vs. 83.0%, respectively, p=0.525), were similar in both groups. 29) The 30-day MAEs rate suggested that DMR patients may have more complications although this was not statistically significant between the 2 groups (FMR 9.2% vs. DMR 14.7%, p=0.281).…”

Short-term and 1-year outcomes after MitraClip therapy in functional versus degenerative mitral regurgitation patients: a systematic review and meta-analysis

“…Notably, FMR patients presented a higher risk profile. The Logistic EuroSCORE was significantly higher in the FMR group (16.0% vs. 22.3%, P<0.001) due to more comorbidities and previous interventions, including previous MI (98/616 vs. 460/1,311, P<0.001), diabetes mellitus (112/641 vs. [11] 35 [13] 56 [7] 64 [11] 35 [9] 51 [12] ----Rudolph (18) 100 100 57 [10] 71 60 [9] 68 [11] 42 [9] 56 [13] ----Tay (19) 100 100 60 [11] 36 [12] 56 [7] 63 [10] 36 [7] 52 [11] 44 [21] 45 [19] --Chan (20) 100 100 46 [14] 32 [17] 57 [9] 64 [9] 35 [7] 50 [13] 51 [16] 48 [ [14] 45 [16] 59 [9] 57 [11] 45 [11] 44 [12] 55 [20] 62 [17] 3.6 [1.7] 3.5 [1.9] Pooled value 99 99 56 [12] 37 [14] 58 [9] 65 [11] 38 [9] 52 [13] 51 [17] 45…”

“…Meanwhile, the remaining 5 cross-sectional studies was pooled into subgroup 2. Subgroup 2 showed the number of DMR patients with implanted MC ≥2 was not significantly greater than that of the FMR patients (RR =1.11; 95% CI: 0.90 to 1.36; P=0.322; I 2 =35.7%) (12,13,(18)(19)(20). Sensitivity analyses were also performed to identify other sources of heterogeneity.…”