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Benito-González et al. Mini-invasive Surg 2020;4:67 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.54

Original Article Open Access

The prognostic impact of frailty in patients
undergoing percutaneous mitral valve repair

Tomás Benito-González , Rodrigo Estévez-Loureiro , Samuel del Castillo , Carlos Minguito-Carazo , Julio
1
1
2
1
Echarte-Morales , Carmen Garrote-Coloma , Felipe Fernández-Vázquez 1
1
1
1 Department of Cardiology, University Hospital of León, León 24071, Spain.
2 Department of Cardiology, University Hospital Alvaro Cunqueiro, Vigo 36213, Spain.
Correspondence to: Dr. Rodrigo Estévez-Loureiro, Department of Cardiology. University Hospital Alvaro Cunqueiro, c/Clara
Campoamor 341, Vigo 36213, Spain. E-mail: roiestevez@hotmail.com
How to cite this article: Benito-González T, Estévez-Loureiro R, del Castillo S, Minguito-Carazo C, Echarte-Morales J, Garrote-
Coloma C, Fernández-Vázquez F. The Prognostic impact of frailty in patients undergoing percutaneous mitral valve repair. Mini-
invasive Surg 2020;4:67. http://dx.doi.org/10.20517/2574-1225.2020.54

Received: 28 May 2020 First Decision: 30 Jul 2020 Revised: 31 Aug 2020 Accepted: 4 Sep 2020 Published: 12 Oct 2020
Academic Editor: Giulio Belli Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: Percutaneous mitral valve repair (PMVR) with MitraClip® has proven to be an effective therapy to reduce
mitral regurgitation in patients at high risk for conventional surgery. This population is currently characterized by
advance age and high prevalence of comorbidities. Our aim was to evaluate the prevalence of frailty in a cohort of
patients undergoing PMVR and its impact on clinical outcomes during follow-up.

Methods: A prospective registry was performed including all consecutive patients who underwent elective PMVR
between June 2014 and March 2018 in our institution. Frailty was evaluated at admission with the functional FRAIL
scale. In-hospital and 30-day procedural outcomes were collected. Clinical follow up was carried out including
New York Heart Association (NYHA) functional class, heart failure hospitalization and death.

Results: Overall, 70 patients were included (mean age 75.3 ± 9.9 years, 65.7% male). Among them, 27 patients
(38.6%) had a pre-procedural FRAIL score greater than 2, meeting frailty criteria. No differences between frail and
non-frail patients were found in technical success (P = 1.0) or 30-day device success (P = 0.739). At six months
follow up, both groups showed a significant improvement in NYHA functional class compared to baseline (frail: P
= 0.002; non-frail: P < 0.001). During a median follow up of 675 (range 416-976) days, frailty patients had a higher
incidence of HF admission and all-cause mortality (P = 0.013). In multivariate COX regression analysis, FRAIL
score greater than 2 was significantly related to the primary composite endpoint (HR = 2.45; 95%CI: 1.02-5.88; P
= 0.044).

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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