Abstract:

Background: Mitral Clip became a well-established interventional option for severe MR in elderly patients with high surgical risk.

Objective: to present 12 patients younger than 65 years with high operative risk treated by TMVR.

Methods: Evaluation of 12 patients younger than 65 years from a total of 250 patients treated by MitraClip® in Westfalen Heart Center, Germany.

Results: Mean age was 57.1 ± 4 years, male gender was 66,7%. The high operative risk was estimated by STS score (mean = 8.76 ± 2.89). The severity of MR was detected by biplane vena contracta (bpVCW) in two perpendicular views (mean = 9.73 ± 1.89 mm). Transmitral mean PG was 1.68 ± 0.75 mmHg. 3 patients showed leaflet prolapse, 5 patients had mitral annular dilatation, 3 patients exhibited mitral leaflet thickening and one patient showed papillary muscle displacement as the main etiology of MR.

Procedural success was achieved in all patients with 1 / 2 / 3 clips implanted in 25% / 75% / 0% of cases. Two grades or more reduction in the severity of MR (MR grade ≤ II/IV) was accomplished in 75% of patients. Mean postprocedural MPG remained within acceptable levels of 4.33 ± 2.31 mmHg. During follow-up, persistent symptomatic improvement was confirmed in all patients who had already shown symptomatic improvement and effective reduction of MR after the procedure. No procedure-related mortality during the first 30 days

Conclusion: MitraClip® in patients younger than 65 years provides satisfactory outcomes at 1 year.