Safety, effectiveness and costs of percutaneous mitral valve repair: A real-world prospective study

Autor: Lee Berry, Nicholas J. Linker, Iain Willits, Hannah Patrick, Robert Henderson, Kim Keltie, Helen Powell, Samuel G. Urwin, Andrew Sims, Helen Cole, Julie Speller, Mark A de Belder
Rok vydání: 2021
Předmět:
Male
Percutaneous
Etiology
Pulmonology
Cardiovascular Procedures
medicine.medical_treatment
Pathology and Laboratory Medicine
Medical Conditions
Medicine and Health Sciences
Prospective Studies
Prospective cohort study
Aged
80 and over
Heart Valve Prosthesis Implantation
Multidisciplinary
MitraClip
Mortality rate
Mitral Valve Insufficiency
Health Care Costs
Middle Aged
Treatment Outcome
Research Design
Heart Valve Prosthesis
cardiovascular system
Engineering and Technology
Mitral Valve
Medicine
Female
Mitral valve regurgitation
Percutaneous Mitral Valve Repair
Research Article
Biotechnology
Adult
medicine.medical_specialty
Death Rates
Clinical Research Design
Science
Surgical and Invasive Medical Procedures
Bioengineering
Research and Analysis Methods
Respiratory Disorders
Population Metrics
medicine
Humans
cardiovascular diseases
Aged
Mitral regurgitation
Mitral valve repair
Population Biology
business.industry
Biology and Life Sciences
medicine.disease
Mitral Valve Repair
Surgery
Dyspnea
Surgical Repair
Medical Devices and Equipment
Adverse Events
business
Zdroj: PLoS ONE, Vol 16, Iss 5, p e0251463 (2021)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0251463
Popis: Aims Percutaneous mitral valve leaflet repair is a treatment option for some people with severe mitral valve regurgitation for whom conventional mitral valve surgery is clinically inappropriate. This study aimed to determine the safety, efficacy, and costs of percutaneous mitral valve leaflet repair, using the MitraClip device in a UK setting. Methods and results This was a prospective, single-armed registry with a follow-up of 2 years that reported a range of procedural, clinical and patient-orientated outcomes. Registry data were linked to routine data sources to allow for more comprehensive follow up concerning mortality and healthcare resource use. The registry received data for 199 mainly elective patients with mixed mitral regurgitation aetiology. A MitraClip device was implanted in 187 patients (94%), with a procedural success rate of 86%, with 8% of patients having a serious in-hospital adverse event (including 5% mortality). Percutaneous mitral valve leaflet repair reduced mitral regurgitation from 100% MR grade ≥ 3+ to 7% at discharge. There were corresponding improvements in New York Heart Association functional class, reducing from 92% (class ≥ 3) at baseline to 18% at 6 weeks. There were significant improvements in generic and disease specific quality of life indicators up to 2 years. The all-cause mortality rate was estimated to be 12.7% (95% CI 7.5 to 17.7%) at 1 year. Percutaneous mitral valve leaflet repair was associated with reduced hospital readmissions and potential cost-savings in post-procedural care. Conclusion This study shows that percutaneous mitral valve leaflet repair using MitraClip is a relatively safe and effective treatment in patients unable to tolerate surgery and has the potential to reduce ongoing healthcare costs in the UK.
Databáze: OpenAIRE
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