The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Percutaneous Edge-To-Edge Mitral Repair in the Presence of Mitral Annulus Calcification

DOI: 10.4244/EIJ-D-21-00205

1. Hospital de la Santa Creu i Sant Pau, Cardiology, Barcelona, Spain
2. Heart Area. Hospital Universitario Central de Asturias, Oviedo, Spain.
3. Hospital Clinic de Barcelona, Institut Clinic Cardiovascular, Barcelona, Spain.
4. Cardiovascular Institute, Hospital Clínico San Carlos, IdISSCMadrid, Spain
5. Interventional Cardiology Unit, Hospital Álvaro Cunqueiro, Vigo, Spain
6. Hospital Clínico Universitario Virgen de la Victoria,CIBERCV, Málaga, Spain.
7. Department of Cardiology, University Hospital of León, León, Spain
8. Cardiology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain, Spain
9. Hospital Clinic de Barcelona, Institut Clinic Cardiovascular, Barcelona, Spain
10. Hospital Clínico Universitario Virgen de la Victoria,CIBERCV, Málaga, Spain
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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.

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