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Prediction for residual regurgitation after MitraClip for functional mitral regurgitation using leaflet coaptation index
Author(s) -
Shim Hunbo,
Harloff Morgan,
Percy Edward,
Hirji Sameer,
Shah Pinak B.,
Kaneko Tsuyoshi
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15008
Subject(s) - mitraclip , medicine , cardiology , mitral regurgitation , confidence interval , odds ratio , functional mitral regurgitation , radiology , heart failure , ejection fraction
Background Given the recent growth in the number of MitraClip procedures in patients with functional mitral regurgitation (MR), there is interest in an echocardiographic index to predict technical success before intervention. We investigated the utility of a novel leaflet coaptation index (LCI) to predict outcomes after MitraClip in functional MR patients. Methods Forty consecutive patients with functional MR who underwent MitraClip were included. The LCI was defined as the coapted leaflet length divided by the anteroposterior diameter of the mitral annulus. The coapted leaflet length was calculated by separately tracing the total length of the mitral valve leaflets at early and end systole on transesophageal echocardiography. The primary endpoint was defined as residual MR ≥ moderate after MitraClip. Results The LCI was significantly associated with residual MR ≥ moderate (odds ratio, 0.827; 95% confidence interval, 0.696–0.982; p = .030) with the cut‐off LCI value of 0.14 (sensitivity 70.4%, specificity 69.2%, c‐statistic 0.815; p = .001). Conclusion This novel index may be a useful adjunct that can be incorporated into the armamentarium of contemporary clinical performance risk prediction tools for MitraClip success.