Percutaneous mitral valve repair – EVEREST II – high risk study

Percutaneous mitral valve repair – EVEREST II – high risk study

Percutaneous mitral valve repair – EVEREST II – high risk study: Mitral valve repair is conventionally the realm of cardiac surgeons. The repair of the mitral valve in cases at high risk of surgery is being done with percutaneously deployed clips {MitraClip device (Abbott Vascular, Santa Clara, California)} to reduce the severity of mitral regurgitation. The EVEREST II – HRS (Endovascular Valve Edge-to-Edge Repair – High Risk Study) evaluated the safety and utility of this approach the acute and one year results are available [1]. Patients enrolled were those deemed high risk for a surgical repair of the mitral valve, with an estimated surgical mortality of twelve percent or above.

Of the seventy eight patients who underwent the MitraClip procedure, more than half had a previous cardiac surgery and the mean age was seventy seven years. The thirty day procedure related mortality was 7.7 percent vs 8.3 percent mortality in the comparator group. The one year survival was seventy six percent, which was significantly better than the fifty five percent survival in the comparator group (p=0.047). Seventy eight percent of the survivors had grade 2 or less of mitral regurgitation at one year. The NYHA (New York Heart Association) functional class was also remarkably better from class III/IV in eighty nine percent at baseline to class I/II in seventy four percent (p<0.0001). Quality of life scores improved and hospitalizations were reduced. Significant reverse remodeling of the left ventricle was also noted at one year.

Reference

1. Whitlow PL, Feldman T, Pedersen WR, Lim DS, Kipperman R, Smalling R, Bajwa T, Herrmann HC, Lasala J, Maddux JT, Tuzcu M, Kapadia S, Trento A, Siegel RJ, Foster E, Glower D, Mauri L, Kar S; EVEREST II Investigators. Acute and 12-Month Results With Catheter-Based Mitral Valve Leaflet Repair – The EVEREST II (Endovascular Valve Edge-to-Edge Repair) High Risk Study. J Am Coll Cardiol, 2012; 59:130-139.