Abstract 18239: Evaluation of Right Ventricular Function in Patients Undergoing Mitraclip Implantation
Background: Patients with severe mitral regurgitation (MR) at high surgical risk can undergo percutaneous mitral valve repair by Mitraclip device implantation, yielding good results in terms of quality of life, MR reduction and improvement of left ventricular (LV) function. Our aim was to assess the changes in right ventricular (RV) function after Mitraclip implantation.
Methods: Forty consecutive patients affected by severe symptomatic MR underwent clinical evaluation and echocardiographic assessment before Mitraclip implantation and during follow-up at 1, 3 and 6 months.
Results: The mean age of patients was 75.8±7.5 years, 57.5% (n=23) were male with a mean logistic EuroSCORE of 32.2%±26.3 and a mean LV ejection fraction (EF%) of 38±11. All patients were symptomatic with 36 (90.0%) in NYHA classIII-IV. Thirty-one patients (77.5%) had functional MR, while 7 (22.5%) had a degenerative MR. Acute device success of implantation was achieved in all patients. One clip was placed in 29 patients (72.5%) while 2 clips were deployed in 11 patients (27.5%). Overall mortality was: 0% in-hospital, 2.9% at 1 month, and 14.7% at 1 year follow-up. We didn’t find significant changes in all others RV parameters. Furthermore no differences in RV function changes were present between degenerative and functional MR groups. A significant mild correlation was found between the improvement of NYHA class and the improvement of RV TDI S’ wave at six month follow-up (r=-0.38, p =0.04).
Conclusion: MitraClip implantation has induced a significant reduction of left ventricular volume overload. The concomitant reduction of left ventricular filling pressure, reflected nearly immediately on clinical profile and on hemodynamics of the right sections. In fact, since the first month of follow up, we observed both a significant reduction of estimated pulmonary artery systolic pressure and a significant increase of longitudinal RV systolic function as shown by the increase of TAPSE and RV S’TDI.
- © 2012 by American Heart Association, Inc.