One-Year Outcomes After MitraClip for Functional Mitral Regurgitation

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Secondary mitral regurgitation (SMR) arises without primary valve disease, often due to left ventricular changes or leaflet tethering.
• Optimal treatment for SMR remains uncertain, necessitating further clinical investigation.
• The EVEREST II trial evaluated transcatheter mitral valve repair for SMR.

Purpose of the Study:

• To assess 1-year adjudicated outcomes of SMR patients treated with the MitraClip device.
• To stratify outcomes based on surgical risk (high-risk vs. non-high-risk).

Main Methods:

• 616 SMR patients (high-risk and non-high-risk) underwent MitraClip.
• Clinical, echocardiographic, and functional data were collected at baseline and 1 year.
• Outcomes were adjudicated across a randomized trial, a high-risk registry, and a continued access registry.

Main Results:

• At 1 year, 76.8% freedom from mortality; 84.7% had MR ≤2+ and 83.0% were NYHA class I/II.
• High-risk patients showed 74.1% survival vs. 86.4% in non-high-risk patients (P=0.0175).
• Both groups achieved comparable MR reduction and left ventricular volume improvement; non-high-risk patients had better NYHA class improvement (P=0.008).
• High-risk patients experienced a significant reduction in heart failure hospitalizations post-procedure.

Conclusions:

• Transcatheter mitral valve repair with MitraClip is safe and effective for SMR.
• The procedure leads to significant MR reduction, symptom relief, and ventricular remodeling.
• MitraClip offers a viable therapeutic option for SMR patients, including those at high surgical risk.