Effect of Left Atrial Volume on Short Term Outcomes Including Functional Status after Transcatheter Mitral Valve Repair

BackgroundTranscatheter mitral valve repair has been increasingly used in patients with high surgical risk with severe degenerative mitral regurgitation (MR). Increased left atrial volume index (LAVI) has been associated with poor long-term prognosis in these patients.MethodsWe evaluated 43 consecutive patients undergoing mitral valve repair with MitraClip device (Abbott) from 2015 to 2018. Echocardiographic parameters and Kansas City Cardiomyopathy Questionnaire score (KCCQ - a validated patient reported quality of life measure) were analyzed. Patients were divided into 2 groups with either LAVI <48ml/cm2 vs LAVI >48ml/cm2 (severely enlarged).ResultsForty-three patients were evaluated with a mean age of 78. There was no difference in baseline comorbidities between the two groups. There was 95.3% procedural success overall. There was no significant difference in procedural duration, length of stay, residual MR and in-hospital adverse events. KCCQ score at 30 days had improved significantly in both groups but there was no difference in magnitude of improvement among the two groups. There was no difference in overall 30 day readmissions/adverse events including heart failure readmissions in the two groups.ConclusionIn this single center study, severely enlarged LAVI was not associated with any significant difference in short term outcomes including functional and quality of life outcomes in patients undergoing valve repair. Transcatheter mitral valve repair has been increasingly used in patients with high surgical risk with severe degenerative mitral regurgitation (MR). Increased left atrial volume index (LAVI) has been associated with poor long-term prognosis in these patients. We evaluated 43 consecutive patients undergoing mitral valve repair with MitraClip device (Abbott) from 2015 to 2018. Echocardiographic parameters and Kansas City Cardiomyopathy Questionnaire score (KCCQ - a validated patient reported quality of life measure) were analyzed. Patients were divided into 2 groups with either LAVI <48ml/cm2 vs LAVI >48ml/cm2 (severely enlarged). Forty-three patients were evaluated with a mean age of 78. There was no difference in baseline comorbidities between the two groups. There was 95.3% procedural success overall. There was no significant difference in procedural duration, length of stay, residual MR and in-hospital adverse events. KCCQ score at 30 days had improved significantly in both groups but there was no difference in magnitude of improvement among the two groups. There was no difference in overall 30 day readmissions/adverse events including heart failure readmissions in the two groups. In this single center study, severely enlarged LAVI was not associated with any significant difference in short term outcomes including functional and quality of life outcomes in patients undergoing valve repair.