Temporal trends of transcatheter edge-to-edge repair in Israel 2019-2020 – data from the Israeli MitraClip Registry (IMCR) - The 68th Annual Conference of the Israel Heart Society in association with the Israel Society of Cardiothoracic Surgery

Mony Shuvy ¹ Doron Sudarsky ² Rafael Wolff ⁶ Lisa Manevich ⁴ Ronen Beeri ³ Paul Fefer ⁷ Leor Perl ⁵ Edward Koifman ⁸ Lion Poles ¹ Sergio Kobal ⁸ Daniel Oren ⁷ Shemy Carasso ² Ran Kornowski ⁵ Haim Danenberg ⁴ Mony Shuvy ⁶

¹Heart Center, Kaplan Medical Center, Israel
²Cardiovascular Institute, Baruch Padeh Medical Center, Israel
³Heart Institute, Hadassah-Hebrew University Medical Center, Israel
⁴Department of Cardiology, Wolfson Medical Center, Israel
⁵Department of Cardiology, Rabin Medical Center, Israel
⁶Jesselson Integrated Heart Centre, Shaare Zedek Medical Center, Israel
⁷Leviev Heart Center, Chaim Sheba Medical Center, Israel
⁸Department of Cardiology, Soroka Medical Center, Israel

Background: MitraClip intervention is increasingly used in patients with severe mitral regurgitation (MR) who are high risk candidates for surgery.

Aim: To describe trends in Israel; patient population, procedural data, shot and intermediate clinical outcomes.

Methods: The Israeli MitraClip registry (IMCR) is a multi-center registry, retrospective since January 2011 and prospective since January 2019 involving 8 active sites in Israel. The registry includes baseline characteristics, procedure data, echocardiographic evaluation, invasive hemodynamics and clinical outcomes.

Results: A total of 228 patients were treated during year 2019, 80% were reported to the registry. There is a steady increase by 30% in MitraClip implantation per year since 2013, mild attenuation was observed during 2020, attributed to COVID-19 pandemic. Higher procedural success rate and shorter procedure time over the years were observed as well. Among 182 reported patients (mean age 76 +/- 10 years, 53% males, average Euroscore II 8.8% +/- 6.7%, average left ventricle ejection fraction 44% +/- 15%). 115 (63%) of patients had functional mechanism of MR. 162 (89%) of the procedures were elective. In 15 cases (8%) MitraCLip was combined with other procedures.

Procedure success, MR grade <= 2 moderate, was achieved in 90% of procedures by one (45%), two (44%) or three clips (11%). In 36 (20%) cases mitral valve gradient was greater than 5 mmHg. 9 procedures were aborted, 4 of which converted to mitral valve surgery. Major complications occurred in 8 procedures in 4 cases pericardiocentesis was performed. The average hospital stay was 6 days (Interquartile 2-7) and 2.3 days in intensive care unit.

Remark: Long term outcomes and hard endpoints are pending and will be available in May 2021.

Conclusion: IMCR is the largest registry in Israel to collect data on percutaneous mitral valve interventions. MitraClip procedure in Israel is safe and with high success rate.