Transcatheter Mitral Valve Repair Using MitraClip in Patients With Renal Transplantation

Objectives. To evaluate the renal function in patients with renal transplantation 1 month after treatment of their severe symptomatic mitral regurgitation using transcatheter mitral valve repair (TMVRep) using MitraClip (Abbott Cardiovascular). Methods. We enrolled 22 patients with previous history of end-stage renal disease and kidney transplant with severe symptomatic mitral regurgitation (MR) in this study. Each patient was evaluated by the structural heart team and underwent transesophageal echocardiographic evaluation for MR etiology, severity, and location of the MR jet, as well as to rule out left atrial appendage clot formation. Serum creatinine and estimated glomerular filtration rate using the Modification of Diet in Renal Disease formula were measured at baseline and at 1-month follow-up. Results. Fourteen patients (64%) were male and mean age of the study group was 50.4 ± 11.0 years. Mean ejection fraction was 29.0 ± 5.6%. The majority (86%) of the MRs treated were classified as functional MR. Follow-up creatinine values were significantly lower after treatment of their symptomatic MR with TMVRep compared with baseline creatinine values (baseline, 3.2 ± 0.49 mg/dL; follow-up, 1.99 ± 0.31 mg/dL; P<.05). Conclusions. TMVRep in patients with renal transplantation was associated with lower serum creatinine values at 1-month follow-up and represents an alternative to surgery in this high-risk group of patients. Further studies are needed to confirm our findings and to find the best treatment option for these patients.