ABSTRACT
Background: The role of the MitraClip implantation in treatment of critically ill patients with heart failure and severe functional mitral regurgitation is undetermined.
Methods: We screened all patients who underwent MitraClip implantation at the Hadassah Medical Center between October 2015 and December 2017. We evaluated immediate, 30-day and 1-year outcomes after the procedure in patients with refractory heart failure and severe functional mitral regurgitation, including patients with acute ischemic mitral regurgitation.
Results: From a cohort of 64 patients, who underwent MitraClip implantation in our center, we identified six critically ill patients (9.4%) with decompensated refractory heart failure and severe functional mitral regurgitation (4+). Patients’ mean age was 69.2 years, 67% were males. One, 2, or 3 clips were implanted in each case. Reduction of mitral regurgitation from grade 4+ to 1+ was achieved in 3 patients (50%), to grade 2+ in 2 patients (33.3%) with significant mean reduction of left atrial V-wave from 46.67 ± 8.50 mmHg to 21.67 ± 6.14 mmHg (p = 0.009). Five patients were weaned from intravenous therapy and intra-aortic balloon pump support 24–72 hours after the procedure. One patient died during hospitalization due to sepsis. Thirty-day follow-up analysis showed improvement of NYHA functional class.
Conclusions: MitraClip therapy could be a “bail-out” option in treatment of critically ill patients with refractory heart failure and severe functional mitral regurgitation.
Disclosure statement
None of the authors has any conflicts of interest. None of the authors have received compensation or grants for the work on this manuscript.