Background: Percutaneous mitral valve repair (MVR) using MitraClip system is a novel technique to treat patients with severe mitral regurgitation (MR) with surgical high risk. In the United States, trials were started in 2003 and the device was approved in 2013. In trials, patients left ventricle ejection fraction (LVEF) less than 20% were excluded. Little is known of the procedure for those patients. This study serves to evaluate clinical outcomes of extra low LVEF MR patients treated with the MitraClip system. Methods: From 2005 to 2016, we treated total 547 patients with symptomatic moderate-to-severe or severe MR using the MitraClip system in our institute. Among those patients, 29 patients with LVEF less than 20%, were evaluated. Results: Mean age at the procedure was 66.6 ± 12.6 years, 76% of patients were male, and mean EF was 15.6 ± 2.5%. The Society of Thoracic Surgeons risk of mortality for replacement was 11.6 ± 12.1. Reason of MR were degenerative: 3%, ischemic: 45%, and non-ischemic: 52%. The MitraClip implant rate was 97%, procedure success rate was 90%, and there was no procedure related complication. Mean number of clips was 1.97 (range 0–4). One patient died and 1 patient needed hospitalization due to heart failure in 30 days. Conclusion: Percutaneous MVR showed effectiveness and safety in extra low LVEF group in short term.
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