• Shmuel Schwartzenberg, Ran Kornowski, Yaron Shapira, Abid Assali, Mordehay Vatury, Leor Perl, Hana Vaknin-Assa, and Alexander Sagie.
• Department of Cardiology, Rabin Medical Center (Beilinson Campus), Petah Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
• Isr Med Assoc J. 2019 May 1; 21 (5): 308-313.

BackgroundThe MitraClip procedure is becoming an acceptable alternative for high-risk patients with mitral regurgitation (MR) due to functional (FMR) or degenerative (DMR) disease and suitable mitral anatomy.ObjectivesTo evaluate the results of MitraClip at our institute in carefully selected patients.MethodsWe conducted a retrospective analysis of medical records and echocardiography data from January 2012 to December 2017.ResultsA total of 39 MitraClip procedures in 37 patients (aged 75 ± 12 years, 9 women) was performed. Twenty-four patients presented with FMR, 12 with DMR, and 1 with combined pathology. One-day post-procedure MR was moderate to low in 86.1% of patients, with immediate device success in 88.8%. MR at 1 year was moderate to low in 79% at 1 year. Survival at 1 year was 86% and at 2 years 69.4%. Peri-procedural (< 1 week) death and MitraClip failure occurred in one and three patients, respectively. New York Heart Association score improved to class 1 or 2 in 37% of patients at 1 year vs. one patient at baseline. Post-procedural systolic pulmonary pressure was reduced from 53 (range 48-65) to 43 (range 36-52) mmHg at 1 month with a subsequent plateau at follow-up, to 41 (34-57) mmHg at 6 months, and to 47 (38-50) at 12 months.ConclusionsMitraClip in severe MR resulted in modest improvement in functional status and pulmonary pressure with a small risk of immediate procedural complications. Outcomes are encouraging considering the natural course of MR and the risks of surgical intervention.

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