Aims: To analyze the safety, efficacy and durability of MitraClip in patients affected with mitral regurgitation (MR) and mitral annulus calcification (MAC). .
Background: MAC is commonly found in patients affected with MR and it’s associated with high morbidity, mortality and worse cardiac surgical outcomes. Transcatheter edge-to-edge repair could be an alternative treatment although with little evidence in this population.
Methods: We analyzed outcomes of 61 suitable patients affected with severe MR and moderate-or-severe MAC (“MAC” group) and 791 patients with no-or-mild MAC (“NoMAC” group) treated with MitraClip.
Results: Procedural success was similar (91,8% vs 95,1%, p=0,268, in MAC and NoMAC respectively) with a very low rate of complications. At one-year follow-up, 90,6% of MAC and 79,5% of NoMAC patients had MR grade ≤2 (p =0,129), 80% in both groups remained in NYHA functional
class ≤II and a significant reduction in cardiac readmissions was observed (65% vs 78% in MAC vs NoMAC, p=0,145). One-year mortality tended to be higher in MAC patients (19,7% vs 11,3%, p=0,050) with no difference in cardiovascular mortality (15,3% vs 9,2%, p=0,129).
Conclusions: MitraClip in selected patients with moderate-or-severe MAC is safe, feasible and achieves good clinical and echocardiographic results at one-year follow-up.