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

Lookup NU author(s): Kim Keltie, Dr Sam Urwin, Helen Cole, Dr Andrew SimsORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2021 Public Library of Science. All rights reserved.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.


Publication metadata

Author(s): Willits I, Keltie K, Belder MD, Henderson R, Linker N, Patrick H, Powell H, Berry L, Speller J, Urwin SG, Cole H, Sims AJ

Publication type: Review

Publication status: Published

Journal: PLoS ONE

Year: 2021

Volume: 16

Issue: 5

Online publication date: 12/05/2021

Acceptance date: 25/04/2021

ISSN (electronic): 1932-6203

Publisher: Public Library of Science

URL: https://doi.org/10.1371/journal.pone.0251463

DOI: 10.1371/journal.pone.0251463

PubMed id: 33979403


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