Use of edge-to-edge percutaneous mitral valve repair for severe mitral regurgitation in cardiogenic shock: A multicenter observational experience (MITRA-SHOCK study)

Giulio Falasconi, Francesco Melillo, Luigi Pannone, Marianna Adamo, Federico Ronco, Azeem Latib, Kusha Rahgozar, Nazario Carrabba, Renato Valenti, Rodolfo Citro, Stefano Stella, Giacomo Ingallina, Cristina Capogrosso, Mara Scandroglio, Francesco Ancona, Cosmo Godino, Paolo Denti, Alessandro Castiglioni, Michele De Bonis, Antonio ColomboLaura Lupi, Luca Branca, Matteo Montorfano, Eustachio Agricola

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The aim of this study was to evaluate the impact of edge-to-edge PMVR on short and mid-term clinical outcomes in patients with CS and severe MR. Background: Severe mitral regurgitation (MR) in the setting of cardiogenic shock (CS) is associated with three times higher risk of 1-year mortality. In refractory CS, edge-to-edge percutaneous mitral valve repair (PMVR) can be a potential therapeutic option. Methods: We retrospectively included consecutive patients with refractory CS and concomitant severe MR treated with MitraClip® system. CS was defined according to the criteria used in the SHOCK trial and procedural success according to Mitral Valve Academic Research Consortium (MVARC) criteria. The 30-day and 6-month mortality were the primary and secondary endpoints respectively. Results: Thirty-one patients (median age 73 years [interquartile range, IQR 66–78], 25.8% female), STS mortality score 37.9 [IQR 30.4–42.4]), with CS and concomitant severe MR treated with edge-to-edge PMVR were retrospectively enrolled. Procedural success was 87.1%. Thirty-day and 6-month survival rates were 78.4 and 45.2% respectively. Univariate Cox Regression Model analysis showed that procedural success was a predictor of both 30-day (HR = 0.12, 95% CI 0.03–0.55, p <.01) and 6-month survival (HR = 0.22, 95% CI 0.06–0.84, p =.027). Conclusions: Edge-to-edge PMVR in patients with CS and concomitant severe MR was associated with good procedural safety and success with acceptable short and mid-term survival rates. It could be considered a bailout option in this setting of patients.

Original languageEnglish (US)
Pages (from-to)E163-E170
JournalCatheterization and Cardiovascular Interventions
Volume98
Issue number1
DOIs
StatePublished - Jul 1 2021

Keywords

  • MitraClip®
  • cardiogenic shock
  • mechanical circulatory support
  • percutaneous mitral valve repair

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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