TY - JOUR
T1 - MitraClip in secondary mitral regurgitation as a bridge to heart transplantation
T2 - 1-year outcomes from the International MitraBridge Registry
AU - Godino, Cosmo
AU - Munafò, Andrea
AU - Scotti, Andrea
AU - Estévez-Loureiro, Rodrigo
AU - Portolés Hernández, Antonio
AU - Arzamendi, Dabit
AU - Fernández Peregrina, Estefanía
AU - Taramasso, Maurizio
AU - Fam, Neil P.
AU - Ho, Edwin C.
AU - Asgar, Anita
AU - Vitrella, Giancarlo
AU - Raineri, Claudia
AU - Adamo, Marianna
AU - Fiorina, Claudia
AU - Montalto, Claudio
AU - Fraccaro, Chiara
AU - Giannini, Cristina
AU - Fiorelli, Francesca
AU - Popolo Rubbio, Antonio
AU - Ooms, J. F.
AU - Compagnone, Miriam
AU - Maffeo, Diego
AU - Bettari, Luca
AU - Fürholz, Monika
AU - Tamburino, Corrado
AU - Petronio, A. Sonia
AU - Grasso, Carmelo
AU - Agricola, Eustachio
AU - Van Mieghem, Nicolas M.
AU - Tarantini, Giuseppe
AU - Curello, Salvatore
AU - Praz, Fabien
AU - Pascual, Isaac
AU - Potena, Luciano
AU - Colombo, Antonio
AU - Maisano, Francesco
AU - Metra, Marco
AU - Margonato, Alberto
AU - Crimi, Gabriele
AU - Saia, Francesco
N1 - Publisher Copyright:
© 2020 International Society for Heart and Lung Transplantation
PY - 2020/12
Y1 - 2020/12
N2 - BACKGROUND: Patients awaiting heart transplantation (HTx) often need bridging therapies to reduce worsening and progression of underlying disease. Limited data are available regarding the use of the MitraClip procedure in secondary mitral regurgitation for this clinical condition. METHODS: We evaluated an international, multicenter (17 centers) registry including 119 patients (median age: 58 years) with moderate-to-severe or severe secondary mitral regurgitation and advanced heart failure (HF) (median left ventricular ejection fraction: 26%) treated with MitraClip as a bridge strategy according to 1 of the following criteria: (1) patients active on HTx list (in list group) (n = 31); (2) patients suitable for HTx but awaiting clinical decision (bridge to decision group) (n = 54); or (3) patients not yet suitable for HTx because of potentially reversible relative contraindications (bridge to candidacy group) (n = 34). RESULTS: Procedural success was achieved in 87.5% of cases, and 30-day survival was 100%. At 1 year, Kaplan–Meier estimates of freedom from the composite primary end-point (death, urgent HTx or left ventricular assist device implantation, first rehospitalization for HF) was 64%. At the time of last available follow-up (median: 532 days), 15% of patients underwent elective transplant, 15.5% remained or could be included in the HTx waiting list, and 23.5% had no more indication to HTx because of clinical improvement. CONCLUSIONS: MitraClip procedure as a bridge strategy to HTx in patients with advanced HF with significant mitral regurgitation was safe, and two thirds of patients remained free from adverse events at 1 year. These findings should be considered exploratory and hypothesis-generating to guide further study for percutaneous intervention in high-risk patients with advanced HF.
AB - BACKGROUND: Patients awaiting heart transplantation (HTx) often need bridging therapies to reduce worsening and progression of underlying disease. Limited data are available regarding the use of the MitraClip procedure in secondary mitral regurgitation for this clinical condition. METHODS: We evaluated an international, multicenter (17 centers) registry including 119 patients (median age: 58 years) with moderate-to-severe or severe secondary mitral regurgitation and advanced heart failure (HF) (median left ventricular ejection fraction: 26%) treated with MitraClip as a bridge strategy according to 1 of the following criteria: (1) patients active on HTx list (in list group) (n = 31); (2) patients suitable for HTx but awaiting clinical decision (bridge to decision group) (n = 54); or (3) patients not yet suitable for HTx because of potentially reversible relative contraindications (bridge to candidacy group) (n = 34). RESULTS: Procedural success was achieved in 87.5% of cases, and 30-day survival was 100%. At 1 year, Kaplan–Meier estimates of freedom from the composite primary end-point (death, urgent HTx or left ventricular assist device implantation, first rehospitalization for HF) was 64%. At the time of last available follow-up (median: 532 days), 15% of patients underwent elective transplant, 15.5% remained or could be included in the HTx waiting list, and 23.5% had no more indication to HTx because of clinical improvement. CONCLUSIONS: MitraClip procedure as a bridge strategy to HTx in patients with advanced HF with significant mitral regurgitation was safe, and two thirds of patients remained free from adverse events at 1 year. These findings should be considered exploratory and hypothesis-generating to guide further study for percutaneous intervention in high-risk patients with advanced HF.
KW - MitraClip
KW - advanced heart failure
KW - heart transplantation
KW - secondary mitral regurgitation
KW - transcatheter mitral valve intervention
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UR - http://www.scopus.com/inward/citedby.url?scp=85091883480&partnerID=8YFLogxK
U2 - 10.1016/j.healun.2020.09.005
DO - 10.1016/j.healun.2020.09.005
M3 - Article
C2 - 33008726
AN - SCOPUS:85091883480
SN - 1053-2498
VL - 39
SP - 1353
EP - 1362
JO - Journal of Heart and Lung Transplantation
JF - Journal of Heart and Lung Transplantation
IS - 12
ER -