2-year outcomes of MitraClip as a bridge to heart transplantation: The international MitraBridge registry

Andrea Raffaele Munafò, Andrea Scotti, Rodrigo Estévez-Loureiro, Marianna Adamo, Antonio Portolés Hernàndez, Estefanìa Fernàndez Peregrina, Lola Gutierrez, Maurizio Taramasso, Neil P. Fam, Edwin C. Ho, Anita Asgar, Giancarlo Vitrella, Claudia Raineri, Giuliano Chizzola, Elisa Pezzola, Robin Le Ruz, Claudio Montalto, Jacopo A. Oreglia, Chiara Fraccaro, Cristina GianniniFrancesca Fiorelli, Antonio Popolo Rubbio, J. F. Ooms, Miriam Compagnone, Chiara Marcelli, Diego Maffeo, Luca Bettari, Monika Fürholz, Dabit Arzamendi, Patrice Guerin, Corrado Tamburino, A. Sonia Petronio, Carmelo Grasso, Eustachio Agricola, Nicolas M. Van Mieghem, Giuseppe Tarantini, Fabien Praz, Isaac Pascual, Luciano Potena, Antonio Colombo, Francesco Maisano, Marco Metra, Alberto Margonato, Gabriele Crimi, Francesco Saia, Cosmo Godino*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)
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Abstract

Background: In the first report from the MitraBridge registry, MitraClip as a bridge to heart transplantation (HTx) proved to be at 1-year an effective treatment strategy for 119 patients with advanced heart failure (HF) who were potential candidates for HTx. We aimed to determine if benefits of MitraClip procedure as a bridge-to-transplant persist up to 2-years. Methods: By the end of the enrollment period, a total of 153 advanced HF patients (median age 59 years, left ventricular ejection fraction 26.9 ± 7.7%) with significant secondary mitral regurgitation, who were potential candidates for HTx and were treated with MitraClip as a bridge-to-transplant strategy, were included in the MitraBridge registry. The primary endpoint was the 2-year composite adverse events rate of all-cause death, first hospitalization for HF, urgent HTx or LVAD implantation. Results: Procedural success was achieved in 89.5% of cases. Thirty-day mortality was 0%. At 2-year, Kaplan-Meier estimates of freedom from primary endpoint was 47%. Through 24 months, the annualized rate of HF rehospitalization per patient-year was 44%. After an overall median follow-up time of 26 (9–52) months, elective HTx was successfully performed in 30 cases (21%), 19 patients (13.5%) maintained or obtained the eligibility for transplant, and 32 patients (22.5%) no longer had an indication for HTx because of significant clinical improvement. Conclusions: After 2-years of follow-up, the use of MitraClip as a bridge-to-transplant was confirmed as an effective strategy, allowing elective HTx or eligibility for transplant in one third of patients, and no more need for transplantation in 22.5% of cases.

Original languageEnglish
Article number131139
JournalInternational Journal of Cardiology
Volume390
Early online date23 Jun 2023
DOIs
Publication statusPublished - 1 Nov 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier B.V.

Funding:
This study was supported by The Natural Science Foundation of Anhui Province (Grant No. 1808085MH229) and Key
Research and Development Program of Anhui Province (Grant No.
202004j07020027).

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