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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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The predictive value of intraprocedural mitral gradient for outcomes after MitraClip and its peri-interventional

Can Öztürk1, Kim Sprenger1, Noriaki Tabata1

  • 1Department of Cardiology, University Hospital Bonn, Bonn, Germany.

Echocardiography (Mount Kisco, N.Y.)
|June 4, 2021
PubMed
Abstract

Insights

Maintaining a mitral gradient below 3.9 mm Hg during MitraClip procedures is crucial for 1-year survival and improved functional outcomes. Echocardiography and procedural data help assess this important metric.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • The impact of elevated mitral gradient (MG) on patient outcomes post-MitraClip is unclear.
  • Intraprocedural assessment of MG presents significant challenges.

Purpose of the Study:

  • To investigate the peri-interventional changes in MG.
  • To determine the effect of intraprocedural MG on clinical outcomes.
  • To identify predictors of unfavorable MG values after MitraClip implantation.

Main Methods:

  • Prospective study of patients undergoing MitraClip.
  • Echocardiography performed at baseline, intraprocedurally, at discharge, and 6-month follow-up.
  • 12-month survival data collected.

Main Results:

  • Intraprocedural MG ≥4.5 mm Hg was the strongest predictor of 12-month mortality (HR: 2.33, P=.03).
  • MG >3.9 mm Hg correlated with adverse functional outcomes (OR: 1.96, P=.04).
  • Baseline leaflet-to-annulus index >1.1 was the strongest predictor of unfavorable intraprocedural MG (OR: 9.74, P=.001).

Conclusions:

  • An intraprocedural MG <3.9 mm Hg is optimal for 1-year survival and functional outcomes after MitraClip.
  • Echocardiographic and procedural parameters aid in assessing intraprocedural MG effectively.
Keywords:
MitraClipmitral gradientmitral regurgitationoutcome

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