eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
3/2018
vol. 14
 
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abstract:
Original paper

Comparison of clinical and echocardiographic outcomes and quality of life in patients with severe mitral regurgitation treated by MitraClip implantation or treated conservatively

Agata Krawczyk-Ożóg, Zbigniew Siudak, Danuta Sorysz, Mateusz K. Hołda, Anna Płotek, Artur Dziewierz, Andrzej Gackowski, Dariusz Dudek

Adv Interv Cardiol 2018; 14, 3 (53): 291–298
Online publish date: 2018/09/21
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Introduction
The most common alternative method of treatment for patients with severe mitral regurgitation (MR) is the implantation of a MitraClip device.

Aim
To evaluate clinical and echocardiographic outcomes and quality of life (QoL) in patients with severe secondary MR, disqualified from surgical intervention, treated by implantation of a MitraClip in comparison to conservative therapy.

Material and methods
A total of 33 patients were included. Patients were stratified by treatment method: group A, MitraClip implantation (n = 10); group B, conservative treatment (n = 23). Clinical, echocardiographic, and QoL (EQ-5D-3L, SF-12v2 Health Survey) characteristics were compared at baseline and at follow-up of 8.0 ±2.3 months.

Results
In group A, 2 deaths were observed: one patient died 7 days after MitraClip implantation, and the second patient died 4 months after the procedure. No cases of rehospitalization were reported. In group B, 4 (17.4%) deaths and 6 (26.1%) hospitalizations were reported. After MitraClip implantation a significant reduction of the NYHA class (p = 0.02), decrease in grade of MR (p = 0.01), vena contracta width (p = 0.006), effective regurgitant orifice area (EROA) (p = 0.003), regurgitant volume (p = 0.03) and end-diastolic left ventricle diameter (p = 0.02) as well as an improvement in QoL were reported. There were no significant changes in the NYHA class and QoL in the group treated conservatively. In those patients, we observed increased intercommissural mitral annulus diameter (p = 0.03), left atrium diameter (p = 0.002), and right ventricle dimension (p = 0.008), more severe tricuspid regurgitation (p = 0.02) and lower mitral annular plane systolic excursion (p = 0.01).

Conclusions
Patients with severe secondary MR treated with the MitraClip achieved a significant reduction in symptoms and MR grade, as well as an improvement in QoL, as compared to patients treated conservatively.

keywords:

MitraClip, heart failure, mitral regurgitation, quality of life

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