Influence of percutaneous mitral valve repair using the MitraClip® system on renal function in patients with severe mitral regurgitation

Catheter Cardiovasc Interv. 2015 Apr;85(5):899-903. doi: 10.1002/ccd.25705. Epub 2014 Oct 28.

Abstract

Background: In patients with mitral regurgitation (MR), changes in cardiac stroke volume, and thus renal preload and afterload may affect kidney function. Percutaneous mitral valve repair (PMVR) with the MitraClip® system can be a therapeutic alternative to surgical valve repair. The influence of MitraClip® therapy on renal function and clinical outcome parameters is unknown.

Methods and results: Sixty patients with severe MR underwent PMVR using the MitraClip® system in an open-label observational study. Patients were stratified according to their renal function. All clips have been implanted successfully. Effective reduction of MR by 2-3 grades acutely improved KDOQI class. Lesser MR reduction (MR reduction of 0-1 grades) led to worsening of renal function in patients with pre-existing normal or mild (KDOQI 1-2) compared to severe (KDOQI 3-4) renal dysfunction. Reduction of MR was associated with improvement in Minnesota Living with Heart Failure Questionnaire (MLHFQ), NYHA-stadium, and 6-minute walk test.

Conclusion: Successful PMVR was associated with an improvement in renal function. The improvement in renal function was associated with the extent of MR reduction and pre-existing kidney dysfunction. Our data emphasize the relevance of PVMR to stabilize the cardiorenal axis in patients with severe MR.

Keywords: chronic; mitral valve disease; percutaneous intervention; renal disease.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disease Progression
  • Echocardiography
  • Female
  • Glomerular Filtration Rate / physiology*
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Mitral Valve / surgery*
  • Mitral Valve Annuloplasty / methods*
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / diagnosis
  • Mitral Valve Insufficiency / surgery*
  • Postoperative Period
  • Renal Insufficiency / complications
  • Renal Insufficiency / physiopathology*
  • Severity of Illness Index
  • Treatment Outcome