Survival After MitraClip Treatment Compared to Surgical and Conservative Treatment for High-Surgical-Risk Patients With Mitral Regurgitation

Friso Kortlandt*, Juliette Velu, Remco Schurer, Tom Hendriks, Ben Van den Branden, Berto Bouma, Ted Feldman, Johannes Kelder, Annelies Bakker, Marco Post, Pim Van der Harst, Frank Eefting, Martin Swaans, Benno Rensing, Jan Baan, Jan Van der Heyden

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)

Abstract

Background-Survival outcome after MitraClip treatment, compared with surgical or conservative treatment, is not well defined. We examined survival after MitraClip treatment in a large multicenter real-life setting.

Methods and Results-We retrospectively formed matched high-risk surgically and conservatively treated control cohorts to compare to a high-risk MitraClip cohort. One thousand thirty-six patients were included in 4 Dutch centers, of which 568 were treated with the MitraClip. The observed survival at 5-year follow-up in our MitraClip cohort was low (39.8%) but was comparable to our conservative cohort (40.5%). Observed 5-year survival for our surgical cohort was 76.3%. However, there were significant differences between the baseline characteristics of the 3 studied cohorts, with the MitraClip cohort having the highest comorbidity burden. After adjusting for baseline differences by using Cox regression, the MitraClip and surgical cohorts showed similar survival ratios (hazard ratio, 0.92; 95% confidence interval, 0.67-1.26; P=0.609), whereas both showed a lower mortality hazard when compared with conservative treatment (hazard ratio, 0.61; 95% confidence interval, 0.49-0.77; P

Conclusions-This matched analysis suggests a lower mortality hazard for MitraClip intervention in a high-risk population with symptomatic mitral regurgitation when compared with conservative management alone.

Original languageEnglish
Article number005985
Number of pages7
JournalCirculation-Cardiovascular interventions
Volume11
Issue number6
DOIs
Publication statusPublished - Jun-2018

Keywords

  • comorbidity
  • conservative treatment
  • mitral valve
  • prognosis
  • uncertainty
  • VALVULAR HEART-DISEASE
  • VALVE REPAIR
  • REGISTRY
  • SURGERY
  • MANAGEMENT
  • MORTALITY
  • SYSTEM

Cite this