Clinical Outcomes Following Urgent vs. Elective Percutaneous Mitral Valve Repair

Aim: To examine procedural and clinical outcomes among patients undergoing percutaneousmitral valve repair (PMVR) within an admission for acute-decompensated heart failure (ADHF). Methods and results: Prospective registry of all consecutive patients with symptomatic mitral regurgitation (MR) grade 3+ or 4+ who underwent PMVR our centre and classified in 2 groups: elective group and urgent PMVR group (within the index admission for ADHF). Echocardiographic, procedural and clinical outcomes were compared between groups. 85 patients (median age 77.0 [67.8-83.4] years, 64.7% male) were treated within the recruitment period. Among them, 17 (20%) underwent urgentMitraClip (R). Urgent PMVRwere at a higher riskfor conventional surgery (p= 0.002) and had worse estimated prognosis according to HF risk scores (p < 0.001). Overall technical successwas 100%, without differences between groups. At 30 days, no differenceswere found in mortality, MR reduction and in NYHA functional improvement between groups. Cumulative estimated survival free from allcause death was 92.9% (82.4% vs. 95.6%), 89.4% (82.4% vs. 91.1%), 76.3% (82.4 vs. 74.9%) at 6 months, 1-year and 2years, respectively, with no significant differences between urgent or elective PMVR (p= 0.769). Conclusion: MitraClip (R) implantation can be considered as an urgent therapy during admission for ADHF. (C) 2020 Elsevier Inc. All rights reserved.