Author + information
- Matthew Dulas,
- Paul Sorajja,
- Kevin Harris,
- Robert Farivar,
- Richard Bae,
- Claudia See,
- Ross Garberich and
- Mario Gössl
Background: Severe degenerative mitral valve regurgitation (DMR) carries an adverse prognosis, yet afflicted patients may not undergo treatment despite availability of contemporary therapy. We sought to examine the relationship between surgical risk, therapeutic penetrance, and survival for patients with MR.
Methods: 169 patients (mean age 75.8 yrs; 48.5% men) with symptomatic DMR (grade 3 or 4) were referred to our institution for consideration of surgery. Risk was calculated using the Society of Thoracic Surgeons (STS) score, and clinical outcomes were examined through a median follow-up period of 9 months.
Results: Of the 169 patients, surgical risk was low (STS <3%), intermediate (3 to 8%), or high (>8%) in 60 (34.9%), 66 (38.4%), and 46 (27.6%) patients, respectively. Overall, 57.0% were treated with Mitraclip or cardiac surgery. Therapeutic penetrance was not related to surgical risk (low 65% vs. intermediate 53.0% vs. high 52.2%; p=0.30). Low-risk, treated patients predominantly received surgery (94.9%), while MitraClip was utilized in 62.9% of intermediate-risk patients and 100% of those at high-risk. Patients who received any mitral valve intervention tended to show a higher survival than untreated patients (Figure).
Conclusions: For patients with symptomatic DMR, the employment of a multidisciplinary approach achieves therapeutic penetrance in the majority of patients across the spectrum of surgical risk, and may be associated with improved long-term survival.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Valvular Disease Populations at Risk
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 1104-031
- 2017 American College of Cardiology Foundation