Clinical features and one year outcomes post mitral valve clip for mitral regurgitation in high-risk patients: Single center experience in Saudi Arabia

Abstract

The current evidence suggests that the primary role for Mitral Valve Clip is to treat symptomatic moderately severe and severe mitral regurgitation (MR) in patients who are either unsuitable or at high risk for MV surgery. Our study is a retrospective observational cohort study for all patients who underwent percutaneous mitral valve clip in our center between June 2013 and October 2016 and who had completed at least one year of follow-up. Symptomatic patients with grades 3 to 4 MR and a high surgical mortality risk, based on the consensus opinion of heart team meeting involving cardiac surgeons, expert interventional cardiologists and echocardiographers were enrolled for percutaneous mitral valve clip. In our cohort, 62 patients had percutaneous mitral valve clip and completed at least 12 months of follow-up. The average age was 60.56 years, 24.19 were females, 50% were diabetic, 46.77 were hypertensive, 12.90 had ESRD and 11.29 % had anemia. Coronary artery disease (CAD) was present in 59.41 %, prior CABG in 11.67 and prior PCI in 35.48. Technically, the procedure was successful in 96.77 % of cases, 24.19 % had 2 clips and 11.29 had 3 clips. The average EF fraction of the left ventricle was 25% and all patients had at least 3/4 MR. regarding the outcome after 1 year of follow-up; the readmission rate was 25.8% and the mortality rate was 14.5%. The readmission and mortality rates post mitral valve clip insertion for symptomatic high risk patients with at least moderate severe MR were lower than the internationally published data but the average age of our patients was 10 years younger. Further studies on larger number of patients are needed to confirm the long term outcome after mitral valve clip.