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EVEREST II Pivotal Study High Risk Registry (HRR)

A Study of the Evalve® Cardiovascular Valve Repair (MitraClip®) System Endovascular Valve Edge-to-Edge REpair STudy (EVEREST II) EVEREST II High Risk Registry

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01940120
Acronym
HRR
Enrollment
78
Registered
2013-09-12
Start date
2007-02-28
Completion date
2013-02-28
Last updated
2018-11-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Mitral Insufficiency, Mitral Regurgitation, Mitral Valve Incompetence, Mitral Valve Insufficiency, Mitral Valve Regurgitation

Keywords

Mitral Valve Insufficiency, Mitral Valve Regurgitation, Mitral Valve Incompetence, Mitral Regurgitation, Mitral Insufficiency, Mitral Valve, MR, Mitral Valve Prolapse, Edge to Edge (E2E), Alfieri Technique, MitraClip, Functional MR, Degenerative MR, Echocardiogram, Coronary Artery Disease (CAD), Heart Failure, Heart Attack, EVEREST, EVEREST I, EVEREST II, REALISM

Brief summary

Prospective, multi-center, single arm registry. Clinical follow-up at discharge, 30 days, 6, 12, 18 and 24, months, and 3, 4 and 5 years. Concurrent Control (CC) group identified retrospectively from the patients screened for the HRR who did not enroll; patient survival determined at 12 months. NCT00209274 (EVEREST II RCT) Intended use Percutaneous reduction of clinically significant mitral regurgitation in symptomatic patients who are considered to be high risk for operative mortality (high surgical risk).

Detailed description

The EVEREST II HRR is a single-arm prospective, multicenter clinical trial enrolling high surgical risk patients of the EVEREST II study (NCT00209274). Patients were considered high surgical risk if either their Society of Thoracic Surgery (STS) predicted operative mortality risk was ≥ 12%, or the surgeon investigator determined the patient to be high risk (≥ 12% predicted operative mortality risk) due to the presence of, at a minimum, one of the following pre-specified risk factors: * Porcelain aorta or mobile ascending aortic atheroma * Post-radiation mediastinum * Previous mediastinitis * Functional MR with ejection fraction (EF) \< 40% * Over 75 years old with EF \< 40% * Prior re-operation with patent grafts * Two or more prior chest surgeries * Hepatic cirrhosis * Three or more of the following STS high risk factors: i. Creatinine \> 2.5 mg/dL ii. Prior chest surgery iii. Age over 75 iv. EF \< 35% Upon completion of enrollment in the HRR, a process was initiated to ensure patient consent to participate in a Concurrent Control (CC) group was in place. Patients were identified to determine survival through 12 months with current standard of care treatment.CC patients were derived from a cohort of patients screened for enrollment in the HRR,yet did not enroll. All patients had moderate-to-severe (3+) or severe (4+) MR based on transthoracic echocardiography (TTE). To be considered eligible for inclusion in the CC group, the patient had to be classified as high surgical risk using the same criteria used for the HRR. Upon follow-up with the clinical sites, it was determined that some of the initially identified patients with moderate-to-severe (3+) or severe (4+) MR met the criteria for high surgical risk. Of these patients, some were not included due to; lack of Institutional Review Board (IRB) approval at the site, lack of informed consent and unable to be contacted. The remaining patients make up the CC group.

Interventions

Procedure/Surgery: Mitral valve repair or replacement surgery Repair or replacement of mitral valve

Sponsors

Abbott Medical Devices
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Candidates for the high risk arm of the study must meet all of the following inclusion criteria: * Predicted procedural mortality risk calculated using the STS surgical risk calculator of ≥ 12% or in the judgment of the surgeon investigator the patient is considered a high risk surgical candidate due to the presence of one of the following indications: 1. Porcelain aorta or mobile ascending aortic atheroma 2. Post-radiation mediastinum 3. Previous mediastinitis 4. Functional MR with EF\<40 5. Over 75 years old with EF\<40 6. Re-operation with patent grafts 7. Two or more prior chest surgeries 8. Hepatic cirrhosis i Three or more of the following STS high risk factors: i) Creatinine \> 2.5 mg/dL ii) Prior chest surgery iii) Age over 75 iv) EF\<35 * Age 18 years or older. * Symptomatic moderate to severe (3+) or severe (4+) chronic mitral regurgitation (MR) and in the judgment of the investigator intervention to reduce MR is likely to provide symptomatic relief for the patient. MR is determined as defined in Appendix A of the EVEREST II study protocol. American Society of Anesthesiologists (ASA) physical status classification of ASA IV or lower. * The primary regurgitant jet originates from malcoaptation of the A2 and P2 scallops of the mitral valve. * Male or Female. Female subjects of childbearing potential must have a negative pregnancy test within seven (7) days before the procedure. * The subject or the subject's legal representative has been informed of the nature of the study and agrees to its provisions and has provided written informed consent as approved by the Institutional Review Board of the respective clinical site. * The subject and the treating physician agree that the subject will return for all required post-procedure follow-up visits. * Transseptal catheterization is determined to be feasible by the treating physician.

Exclusion criteria

Candidates will be excluded from the study if any of the following conditions are present: * Evidence of an acute myocardial infarction in the prior 2 weeks of the intended treatment (defined as: Q wave or non-Q wave infarction having creatine kinase (CK) enzymes ≥ two times (2X) the upper laboratory normal limit with the presence of a Creatine Kinase MB Isoenzyme (CKMB) elevated above the institution's upper limit of normal). * In the judgment of the Investigator, the femoral vein cannot accommodate a 24 F catheter or presence of ipsilateral deep vein thrombosis (DVT). * Ejection fraction \< 20%, and/or end-systolic dimension \> 60 mm as defined in Appendix A of the EVEREST II protocol. * Mitral valve orifice area \< 4.0 cm2 as defined in Appendix A of the EVEREST II protocol. * If leaflet flail is present: 1. Flail Width: the width of the flail segment is greater than or equal to 15 mm, as defined in Section 4.3 and Appendix A, or 2. Flail Gap: the flail gap is greater than or equal to 10 mm, as defined in Section 4.3 and Appendix A. * If leaflet tethering is present: a). Coaptation Length: the vertical coaptation length is less than 2 mm, as defined in Section 4.3 and Appendix A. * Leaflet anatomy which may preclude clip implantation, proper clip positioning on the leaflets or sufficient reduction in MR. This may include: * Evidence of calcification in the grasping area of the A2 and/or P2 scallops * Presence of a significant cleft of A2 or P2 scallops * More than one anatomic criteria dimensionally near the exclusion limits * Bileaflet flail or severe bileaflet prolapse * Lack of both primary and secondary chordal support * Hemodynamic instability defined as systolic pressure \< 90 mmHg without after load reduction or cardiogenic shock or the need for inotropic support or intra-aortic balloon pump. * Need for emergent or urgent surgery for any reason. * Prior mitral valve leaflet surgery or any currently implanted mechanical prosthetic mitral valve. * Echocardiographic evidence of intracardiac mass, thrombus or vegetation. * Active endocarditis or active rheumatic heart disease or leaflets degenerated from rheumatic diseased (i.e. noncompliant, perforated). * History of bleeding diathesis or coagulopathy or subject will refuse blood transfusions. * Active infections requiring current antibiotic therapy (if temporary illness, patients may enroll 2 weeks after discontinuation of antibiotics). Patients must be free from infection prior to treatment. Any required dental work should be completed a minimum of 3 weeks prior to treatment. * Intravenous drug abuse or suspected inability to adhere to follow-up. * Patients in whom transesophageal echocardiography (TEE) is contraindicated. * A known hypersensitivity or contraindication to study or * In the judgment of the Investigator, patients in whom the presence of a permanent pacemaker or pacing leads would interfere with placement of the test device or the placement of the test device would disrupt the leads. * Currently participating in an investigational drug or another device study that has not completed the primary endpoint or that clinically interferes with the current study endpoints. \[Note: Trials requiring extended follow-up for products that were investigational, but have since become commercially available, are not considered investigational trials\].

Design outcomes

Primary

MeasureTime frameDescription
Composite Functional and Structural Measures - Freedom From Death12 monthsDefined as all causes of death for the primary safety Major Adverse Event (MAE) Endpoint. Death is further divided into 2 categories: A. Cardiac death is defined as death due to any of the following: 1. Acute myocardial infarction. 2. Cardiac perforation/pericardial tamponade. 3. Arrhythmia or conduction abnormality. 4. Stroke within 30 days of the procedure or stroke suspected of being related to the procedure. 5. Death due to any complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery. 6. Any death for which a cardiac cause cannot be excluded. B. Non-cardiac death is defined as a death not due to cardiac causes (as defined above).
Percentage of Participants With Freedom From Death and Mitral Regurgitation (MR) >2+12 monthsKaplan-Meier estimated percentage of patients who are alive and have a mitral regurgitation severity grade of 2+ or less
Number of Participants With Clinical Measures of Benefit-New York Heart Association (NYHA) Class30 daysThe major effectiveness endpoint is an assessment of multiple functional and structural measures of benefit including New York Heart Association (NYHA) Class. Class I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.
Number of Participants With New York Heart Association (NYHA) Class12 monthsClass I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.
Clinical Measures of Benefit-Quality of Life (QOL) as Measured by Short Form (SF) 3612 monthsStandardized quality of life surveys allow physicians to evaluate the effectiveness of different treatment methods and the physical and psychological benefits a patient is likely to receive from a particular treatment.In the EVEREST II HRR,the patients were asked to complete the SF-36 QOL survey at baseline, 30 days and 12 months. The physical & mental function were assessed by the Physical Component Summary (PCS) score & Mental Component Summary (MCS) score. The PCS & MCS norms for 65-75 year olds are 44 and 52 respectively; and 31 & 46 for congestive heart failure (CHF) patients respectively. Each scale from the SF-36 is an algebraic sum of responses for all items in that scale.For ease of analysis each scale is then transformed to a 0-100 scale using a formula that converts the lowest & highest possible scores to 0 & 100 respectively.The scoring of the SF-36 indicates that 0% in a domain represents the poorest possible QoL & 100% indicates full QoL.
Left Ventricular End Diastolic Volume (LVEDV)12 monthsLeft Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).
Left Ventricular End Systolic Volume (LVESV)12 monthsLeft Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).
Left Ventricular (LV) Function - Internal Dimension12 monthsLeft Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).
Number of Patients With CHF Having Hospitalization During Discharge Through 12 Months12 monthsNumber of patients with incidence of re-hospitalizations for CHF in the 12-months after the MitraClip implant procedure.
Number of CHF Events Leading to Hospitalizations During Discharge Through 12 Months12 monthsIncidence of re-hospitalizations for CHF in the 12-months after the MitraClip implant procedure.

Secondary

MeasureTime frameDescription
Number of Participants With Endocarditis30 daysUsing Duke Criteria, endocarditis can be confirmed by: Pathological criteria: Endocarditis is confirmed if microorganisms are identified by culture or histology in a vegetation, embolized vegetation, or an intracardiac abscess; or if pathological lesions are observed & histologically confirmed showing active endocarditis. Clinical criteria: Endocarditis is confirmed by the presence of 2 major criteria, 1 major plus 3 minor criteria, or 5 minor criteria. Major criteria include persistently +ve blood cultures with the presence of typical organisms for endocarditis; persistent bacteremia; evidence of endocardial involvement with positive echocardiogram with signs of oscillating vegetation, abscesses, valve perforation, new partial dehiscence of prosthetic valve or new valvular regurgitation. Minor criteria include predisposing heart condition, fever, vascular phenomena, immunologic phenomena, & positive blood culture or echocardiogram not meeting major criteria.
Number of Participants With Atrial Septal Defect (ASD)30 daysOccurrence of clinically significant ASD as a result of the procedure requiring intervention.
Number of Participants With Mitral Valve Stenosis30 daysMitral stenosis associated with a total mitral valve orifice area less than 1.5 cm2.
Mitral Valve Area: By Planimetry30 daysMitral valve area as measured by core lab echocardiography.
Mitral Valve Area: By Pressure Half-time30 daysMitral valve area as measured by core lab echocardiography.
Mitral Valve Area Index : By Planimetry30 daysMitral valve area as measured by core lab echocardiography by planimetry and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].
Mitral Valve Area (MVA) Index: by Pressure-Half Time Formula30 daysMitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to Body surface area (BSA). \[MVA Index = MVA (cm\^2)/BSA (m\^2)\]
Mitral Valve Area Index : By Pressure Half-time Formula12 monthsMitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].
Transvalvular Mitral Valve Gradient30 daysDefined as the mean pressure gradients across the mitral valve as measured by echocardiography.
Mitral Valve Index30 daysMitral valve area as measured by core lab echocardiography and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\]
Number of Participants With New Coumadin Use30 daysNew onset use of Coumadin or warfarin to treat a potential thrombus on a defibrillator lead.
Number of Participants Discharged to a Nursing Home or Skilled Nursing Facility or Hospital30 DaysDischarge to a nursing home or skilled nursing facility following discharge from the hospital after definitive treatment.
Post-procedure Length of Hospital StayLength of Hospital Stay, assessed at 30 daysDefined as the number of days from the end of the procedure until the patient is discharged from the hospital. This does not include time in a nursing or skilled care facility.
Post-procedure Intensive Care Unit (ICU)/ Critical Care Unit (CCU) TimeLength of ICU/CCU stay, assessed at 30 DaysNumber of hours patients are in an intensive care unit or step down unit before discharge or moving to a standard care unit.
Number of Participants With Successful Clip Implant30 DaysRate of successful delivery and deployment of Clip implants with echocardiographic evidence of leaflet approximation and retrieval of the investigational delivery catheter.
Number of Participants With High Risk Procedural Success30 daysSuccessful implantation of the Clip (s) with resulting MR severity of 2+ of less at discharge or a 1 grade MR reduction at discharge accompanied by a 1 level reduction in NYHA.
Number of Participants With MR SeverityDischarge or 30 daysMR Severity: Site-assessed mitral regurgitation severity using echocardiography. MR severity is graded on a scale of 0+ to 4+ where 0+ means absence of mitral regurgitation, 1+ is mild, 1+ to 2+ is mild-to-moderate, 2+ to 3+ is moderate to moderate-to-Severe, 3+ is moderate-to-severe, 3+ to 4+ is moderate-to-severe to severe, 4+ is severe.
Number of Participants With Treatment Durability12 monthsDefined as the proportion of Acute Procedural Success patients with MR severity grade of 2+ or less that have not required surgery for valve dysfunction.
Number of Participants With Clinical Durability12 monthsProportion of patients who have an acute reduction in MR severity of at least one grade (as measured by the discharge echocardiogram) that have not required surgery for valve dysfunction and meet either of the following: 1) MR severity grade of 2+ or less or 2) a one grade reduction in MR severity compared to baseline accompanied by at least a one level reduction in NYHA.
Number of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) Class24 monthsClass I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.
Number of Participants With New York Heart Association (NYHA) Class60 monthsClass I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.
Left Ventricular End-diastolic Volume (LVEDV).24 monthsLeft Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).
Left Ventricular End-systolic Volume (LVESV).24 monthsLeft Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).
Left Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)24 monthsLeft Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).
Number of Days Re-hospitalized for CHF12 monthsDefined as the number of days hospitalized for CHF in the 12-months prior to the Clip implant procedure date compared to the number of days re-hospitalized for CHF in the 12-months after Clip implant.
Number of Hospital Re-Admissions for Congestive Heart Failure (CHF)12 monthsDefined as the number of hospital admissions (i.e. events) for which the primary diagnosis for hospitalization is congestive heart failure, in the 12-months post-discharge following the MitraClip procedure.
Regurgitant Volume30 daysRegurgitant volume as measured by the core echocardiographic laboratory at follow-up.
Regurgitant Fraction (RF)30 daysRF is defined as the percentage of the left ventricular (LV) stroke volume that regurgitates into the left atrium.
Number of Participants With Major Bleeding Complications30 daysDefined as procedure related bleeding that requires a transfusion of ≥2 units of blood and/or surgical intervention.
Cardiac Output (CO)30 DaysCO is defined as the volume of blood pumped by the left ventricle per unit time (L/min).
Cardiac Output12 monthsCO is defined as the volume of blood pumped by the left ventricle per unit time (L/min)
Cardiac Index30 DaysCardiac index (cardiac output divided by body surface area) as measured by core lab echocardiography.
Left Ventricular Ejection Fraction (LVEF)Discharge or 30 daysLeft Ventricular Ejection Fraction (LVEF) as determined by the core echocardiography laboratory.
Percentage of Participants With Freedom From Mitral Valve SurgeryBaselinePercentage of patients who did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure
Number of Participants With Mitral Valve Repair Success12 monthsMitral Valve Repair Success defined as freedom from mitral valve replacement surgery for valve dysfunction, death, re-operation and MR \> 2+ at 12 months.
Composite Functional and Structural Measures - Percentage of Participants With Freedom From Death24 monthsDefined as all causes of death for the primary safety Major Adverse Event (MAE) Endpoint. Death is further divided into 2 categories: A. Cardiac death is defined as death due to any of the following: 1. Acute myocardial infarction. 2. Cardiac perforation/pericardial tamponade. 3. Arrhythmia or conduction abnormality. 4. Stroke within 30 days of the procedure or stroke suspected of being related to the procedure. 5. Death due to any complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery. 6. Any death for which a cardiac cause cannot be excluded. B. Non-cardiac death is defined as a death not due to cardiac causes (as defined above).
Percentage of Participants With Composite Functional and Structural Measures - Freedom From Death and MR >2+24 monthsKaplan-Meier estimated proportion of patients who are alive and have a mitral regurgitation severity grade of 2+ or less.
Number of Participants With Device Embolization or Single Leaflet Device Attachment0 to 12 monthsDevice embolization is defined as bilateral Clip detachment resulting in Clip embolization. Reasons for Clip embolization include leaflet tearing, Clip unlocking, Clip fracture or inadequate Clip placement (i.e., malposition). Not included are any fractures or other failures of the Clip that do not result in Clip detachment from both leaflets. A single leaflet device attachment (SLDA) is defined as attachment of one mitral valve leaflet to the MitraClip device.
Number of Participants With Mitral Valve Surgery Post-MitraClip Procedure60 monthsNumber of patients who underwent surgical mitral valve repair or replacement after the index MitraClip procedure.
Number of Participants With Second MitraClip Device Implanted0 to 5 yearsIt is a summary of re-interventions to place an additional MitraClip Device.
Percentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery12 monthsKaplan-Meier estimate of the percentage of patients who are alive and did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure
Number of Participants With Mitral Valve Replacement12 monthsDefined as how often patients receiving surgery required replacement of the mitral valve.
Regurgitant Fraction12 monthsRF is defined as the percentage of the left ventricular (LV) stroke volume that regurgitates into the left atrium.
Number of Participants Experiencing Major Adverse Events (MAE)30 daysCombined clinical endpoint of death, myocardial infarction, reoperation for failed surgical repair or replacement, nonelective cardiovascular surgery for adverse events, stroke, renal failure, deep wound infection, ventilation for greater than 48 hours, GI complication requiring surgery, new onset of permanent atrial fibrillation, septicemia, and transfusion of 2 or more units of blood.
Number of Participants Experiencing Major Adverse Events12 monthsCombined clinical endpoint of death, myocardial infarction, reoperation for failed surgical repair or replacement, nonelective cardiovascular surgery for adverse events, stroke, renal failure, deep wound infection, ventilation for greater than 48 hours, GI complication requiring surgery, new onset of permanent atrial fibrillation, septicemia, and transfusion of 2 or more units of blood.
Procedural Freedom From In-hospital MAE30 DaysPercutaneous Clip procedure or surgery with no occurrence of in-hospital MAE.
Number of Participants Over 75 Years of Age With MAE30 daysCombined clinical endpoint of death, myocardial infarction, reoperation for failed surgical repair or replacement, nonelective cardiovascular surgery for adverse events, stroke, renal failure, deep wound infection, ventilation for greater than 48 hours, GI complication requiring surgery, new onset of permanent atrial fibrillation, septicemia, and transfusion of 2 or more units of blood.
Number of Participants Experiencing Major Vascular Complications30 daysDefined as the occurrence of any of the following resulting from the index procedure: * Hematoma at access site \>6 cm; * Retroperitoneal hematoma; * Arterial-venous fistula; * Symptomatic peripheral ischemia/ nerve injury with clinical signs or symptoms lasting \>24 hours; * Vascular surgical repair at catheter access sites; * Pulmonary embolism; * Ipsilateral deep vein thrombus; or * Access site-related infection requiring intravenous antibiotics and/or extended hospitalization.
Number of Participants With Non-cerebral Thromboembolism30 daysDefined as any mural thrombus or thromboembolism in the vasculature (excluding central nervous system events) confirmed by standard clinical and laboratory testing and which requires intervention.
Number of Participants With Thrombosis30 daysEvidence of formation of an independently moving thrombus on any part of the Clip or any commercially available implant used during surgery by echocardiography or fluoroscopy. If Clip is explanted or an autopsy is performed this diagnosis should be confirmed.
Number of Participants With Hemolysis30 daysDefined as new onset of anemia associated with laboratory evidence of red cell destruction. Diagnosed when plasma free hemoglobin is greater than 40 mg/dL on two measures within 24 hours or on one measure if intervention is initiated based on other clinical symptoms
Number of Participants With Dysrhythmias30 daysIncludes all new onset atrial fibrillation and heart block requiring placement of a permanent pacemaker.

Countries

United States

Participant flow

Recruitment details

Patients who met eligibility criteria for the study and had a MitraClip procedure, whether a Device was implanted or not, were considered enrolled in the Registry. A total of 78 patients were enrolled at 35 North American sites. Screening period: Jan, 2007-2008. Enrollment period: Feb 14, 2007- Jan 30, 2008.

Participants by arm

ArmCount
High Risk Registry Arm
Includes patients with a predicted procedural mortality of 12% or higher. The high risk registry arm of the study is powered to show superiority of safety of treatment with the MitraClip compared to mitral valve surgery. The patients who are enrolled in this arm will undergo percutaneous mitral valve repair using MitraClip implant.
78
Total78

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyDeath40
Overall StudyWithdrawal by Subject8

Baseline characteristics

CharacteristicHigh Risk Registry Arm
36-Item Short Form Health Survey (SF-36) Quality of Life
Mental Health (MCS)
44.2 scores on a scale
STANDARD_DEVIATION 12.6
36-Item Short Form Health Survey (SF-36) Quality of Life
Physical Health (PCS)
31.6 scores on a scale
STANDARD_DEVIATION 9.1
Age, Continuous76.7 years
STANDARD_DEVIATION 9.8
Age, Customized
18-75 years
30 participants
Age, Customized
>75 years
48 participants
LV Measurement
Left Ventricular End Diastolic Volume (LVEDV)
166.5 mL
STANDARD_DEVIATION 50.7
LV Measurement
Left Ventricular End Systolic Volume (LVESV)
79.9 mL
STANDARD_DEVIATION 42.7
LV Measurement
Left Ventricular Internal Diameter Diastole(LVIDd)
5.6 cm
STANDARD_DEVIATION 0.7
LV Measurement
Left Ventricular Internal Diameter Systole (LVIDs)
3.9 cm
STANDARD_DEVIATION 1.1
Number of CHF events leading to hospitalizations during 12 months before enrollment51 events
Number of hospitalization days for CHF at 12 months before enrollment6.0 days
STANDARD_DEVIATION 4.6
Number of patients hospitalized for CHF during 12 months before enrollment
Number of patients hospitalized for CHF
33 participants
Number of patients hospitalized for CHF during 12 months before enrollment
Number of patients not hospitalized for CHF
45 participants
NYHA Functional Class
NYHA Functional Class I
0 participants
NYHA Functional Class
NYHA Functional Class II
8 participants
NYHA Functional Class
NYHA Functional Class III
47 participants
NYHA Functional Class
NYHA Functional Class IV
23 participants
Predicted Surgical Mortality18.2 Probability percentage
STANDARD_DEVIATION 8
Region of Enrollment
Canada
1 participants
Region of Enrollment
United States
77 participants
Sex: Female, Male
Female
29 Participants
Sex: Female, Male
Male
49 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
25 / 78
other
Total, other adverse events
77 / 78
serious
Total, serious adverse events
69 / 78

Outcome results

Primary

Clinical Measures of Benefit-Quality of Life (QOL) as Measured by Short Form (SF) 36

Standardized quality of life surveys allow physicians to evaluate the effectiveness of different treatment methods and the physical and psychological benefits a patient is likely to receive from a particular treatment.In the EVEREST II HRR,the patients were asked to complete the SF-36 QOL survey at baseline, 30 days and 12 months. The physical & mental function were assessed by the Physical Component Summary (PCS) score & Mental Component Summary (MCS) score. The PCS & MCS norms for 65-75 year olds are 44 and 52 respectively; and 31 & 46 for congestive heart failure (CHF) patients respectively. Each scale from the SF-36 is an algebraic sum of responses for all items in that scale.For ease of analysis each scale is then transformed to a 0-100 scale using a formula that converts the lowest & highest possible scores to 0 & 100 respectively.The scoring of the SF-36 indicates that 0% in a domain represents the poorest possible QoL & 100% indicates full QoL.

Time frame: 12 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureGroupValue (MEAN)Dispersion
High Risk Registry ArmClinical Measures of Benefit-Quality of Life (QOL) as Measured by Short Form (SF) 36PCS36.1 score on a scaleStandard Deviation 10.8
High Risk Registry ArmClinical Measures of Benefit-Quality of Life (QOL) as Measured by Short Form (SF) 36MCS48.7 score on a scaleStandard Deviation 11.9
Primary

Composite Functional and Structural Measures - Freedom From Death

Defined as all causes of death for the primary safety Major Adverse Event (MAE) Endpoint. Death is further divided into 2 categories: A. Cardiac death is defined as death due to any of the following: 1. Acute myocardial infarction. 2. Cardiac perforation/pericardial tamponade. 3. Arrhythmia or conduction abnormality. 4. Stroke within 30 days of the procedure or stroke suspected of being related to the procedure. 5. Death due to any complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery. 6. Any death for which a cardiac cause cannot be excluded. B. Non-cardiac death is defined as a death not due to cardiac causes (as defined above).

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmComposite Functional and Structural Measures - Freedom From Death59 Participants
Primary

Left Ventricular End Diastolic Volume (LVEDV)

Left Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 12 months

Population: Of 78 total population, 54 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and LVEDV was not done or un-evaluable in 2 patients.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End Diastolic Volume (LVEDV)139.7 mlStandard Deviation 42.6
Primary

Left Ventricular End Diastolic Volume (LVEDV)

Left Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: Discharge or 30 days

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End Diastolic Volume (LVEDV)147.9 mlStandard Deviation 48.8
Primary

Left Ventricular End Systolic Volume (LVESV)

Left Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 12 months

Population: Of 78 total population, 54 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and LVESV was not done or un-evaluable in 2 patients.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End Systolic Volume (LVESV)72.2 mlStandard Deviation 35.8
Primary

Left Ventricular End Systolic Volume (LVESV)

Left Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: Discharge or 30 days

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End Systolic Volume (LVESV)74.3 mlStandard Deviation 40.4
Primary

Left Ventricular (LV) Function - Internal Dimension

Left Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 12 months

Population: Of 78 total population, 54 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and LIVDs/LVIDs evaluation was not done or un-evaluable in 2 patients.

ArmMeasureGroupValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular (LV) Function - Internal DimensionLV Internal Dimension diastole (LVIDd)5.3 cmStandard Deviation 0.7
High Risk Registry ArmLeft Ventricular (LV) Function - Internal DimensionLV Internal Dimension systole (LVIDs)3.8 cmStandard Deviation 1
Primary

Left Ventricular (LV) Function - Internal Dimension

Left Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: Discharge or 30 days

ArmMeasureGroupValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular (LV) Function - Internal DimensionLV Internal Dimension diastole (LVIDd)5.4 cmStandard Deviation 0.8
High Risk Registry ArmLeft Ventricular (LV) Function - Internal DimensionLV Internal Dimension systole (LVIDs)3.9 cmStandard Deviation 1
Primary

Number of CHF Events Leading to Hospitalizations During Discharge Through 12 Months

Incidence of re-hospitalizations for CHF in the 12-months after the MitraClip implant procedure.

Time frame: 12 months

Population: Three patients died before discharge and thus do not provide data on post-discharge hospitalizations.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of CHF Events Leading to Hospitalizations During Discharge Through 12 Months22 Participants
Primary

Number of Participants With Clinical Measures of Benefit-New York Heart Association (NYHA) Class

The major effectiveness endpoint is an assessment of multiple functional and structural measures of benefit including New York Heart Association (NYHA) Class. Class I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

Time frame: 30 days

Population: 71 out of 78 patients (at baseline) were analyzed at 30 days. There were 6 deaths prior to 30 days. So, NYHA at 30 days is missing due to death in 6 patients, and missing due to other reasons in 1 patient.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class I14 Participants
High Risk Registry ArmNumber of Participants With Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class II38 Participants
High Risk Registry ArmNumber of Participants With Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class III16 Participants
High Risk Registry ArmNumber of Participants With Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class IV3 Participants
Primary

Number of Participants With New York Heart Association (NYHA) Class

Class I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

Time frame: 12 months

Population: Of 78 total population, 54 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and 2 patients without NYHA Class assessment.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class IV1 Participants
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class I18 Participants
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class II22 Participants
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class III13 Participants
Primary

Number of Patients With CHF Having Hospitalization During Discharge Through 12 Months

Number of patients with incidence of re-hospitalizations for CHF in the 12-months after the MitraClip implant procedure.

Time frame: 12 months

Population: Three patients died before discharge and thus do not provide data on post-discharge hospitalizations.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Patients With CHF Having Hospitalization During Discharge Through 12 Months12 Participants
Primary

Percentage of Participants With Freedom From Death and Mitral Regurgitation (MR) >2+

Kaplan-Meier estimated percentage of patients who are alive and have a mitral regurgitation severity grade of 2+ or less

Time frame: 12 months

ArmMeasureGroupValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From Death and Mitral Regurgitation (MR) >2+Primary Analysis56.4 percentage of participants
High Risk Registry ArmPercentage of Participants With Freedom From Death and Mitral Regurgitation (MR) >2+Worst case Analysis53.8 percentage of participants
Secondary

Cardiac Index

Cardiac index (cardiac output divided by body surface area) as measured by core lab echocardiography.

Time frame: 30 Days

Population: Of 78 total population, 66 participants were included in the analysis population because of 6 deaths within 30 days and in 6 participants cardiac Index was un-evaluable or not done.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmCardiac Index2 l/min/m2Standard Deviation 0.6
Secondary

Cardiac Index

Cardiac index (cardiac output divided by body surface area) as measured by core lab echocardiography.

Time frame: 24 months

Population: Of 78 total population, 40 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and in 4 patients cardiac index evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmCardiac Index1.8 l/min/m2Standard Deviation 0.4
Secondary

Cardiac Index

Cardiac index (cardiac output divided by body surface area) as measured by core lab echocardiography.

Time frame: 12 months

Population: Of 78 total population, 53 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 3 patients Cardiac Index evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmCardiac Index2 l/min/m2Standard Deviation 0.5
Secondary

Cardiac Output

CO is defined as the volume of blood pumped by the left ventricle per unit time (L/min)

Time frame: 12 months

Population: Of 78 total population, 53 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 3 patients Cardiac output evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmCardiac Output3.8 l/minStandard Deviation 1
Secondary

Cardiac Output

CO is defined as the volume of blood pumped by the left ventricle per unit time (L/min)

Time frame: 24 months

Population: Of 78 total population, 40 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and in 4 patients Cardiac output evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmCardiac Output3.5 l/minStandard Deviation 0.9
Secondary

Cardiac Output (CO)

CO is defined as the volume of blood pumped by the left ventricle per unit time (L/min).

Time frame: 30 Days

Population: Of 78 total population, 66 participants were included in analysis population because of 6 deaths within 30 days and in 6 patients Cardiac Output was not assessed or or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmCardiac Output (CO)3.8 l/minStandard Deviation 1.2
Secondary

Composite Functional and Structural Measures - Percentage of Participants With Freedom From Death

Defined as all causes of death for the primary safety Major Adverse Event (MAE) Endpoint. Death is further divided into 2 categories: A. Cardiac death is defined as death due to any of the following: 1. Acute myocardial infarction. 2. Cardiac perforation/pericardial tamponade. 3. Arrhythmia or conduction abnormality. 4. Stroke within 30 days of the procedure or stroke suspected of being related to the procedure. 5. Death due to any complication of the procedure, including bleeding, vascular repair, transfusion reaction, or bypass surgery. 6. Any death for which a cardiac cause cannot be excluded. B. Non-cardiac death is defined as a death not due to cardiac causes (as defined above).

Time frame: 24 months

Population: Analysis population includes 46 participants, which represents the number of patients at risk as per Kaplan-Meier freedom from mortality analysis at 24 months.

ArmMeasureValue (NUMBER)
High Risk Registry ArmComposite Functional and Structural Measures - Percentage of Participants With Freedom From Death64.6 percentage of participants
Secondary

Left Ventricular Ejection Fraction (LVEF)

Left Ventricular Ejection Fraction (LVEF) as determined by the core echocardiography laboratory.

Time frame: Discharge or 30 days

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Ejection Fraction (LVEF)52.3 percentage of ejection fractionStandard Deviation 12.4
Secondary

Left Ventricular Ejection Fraction (LVEF)

Left Ventricular Ejection Fraction (LVEF) as determined by the core echocardiography laboratory.

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Ejection Fraction (LVEF)51.5 percentage of ejection fractionStandard Deviation 13.6
Secondary

Left Ventricular Ejection Fraction (LVEF)

Left Ventricular Ejection Fraction (LVEF) as determined by the core echocardiography laboratory.

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Ejection Fraction (LVEF)49.9 percentage of ejection fractionStandard Deviation 12.6
Secondary

Left Ventricular Ejection Fraction (LVEF)

Left Ventricular Ejection Fraction (LVEF) as determined by the core echocardiography laboratory.

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Ejection Fraction (LVEF)52.5 percentage of ejection fractionStandard Deviation 12.5
Secondary

Left Ventricular Ejection Fraction (LVEF)

Left Ventricular Ejection Fraction (LVEF) as determined by the core echocardiography laboratory.

Time frame: 24 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Ejection Fraction (LVEF)49.5 percentage of ejection fractionStandard Deviation 12
Secondary

Left Ventricular Ejection Fraction (LVEF)

Left Ventricular Ejection Fraction (LVEF) as determined by the core echocardiography laboratory.

Time frame: 12 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Ejection Fraction (LVEF)50.2 percentage of ejection fractionStandard Deviation 13.1
Secondary

Left Ventricular End-diastolic Volume (LVEDV).

Left Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-diastolic Volume (LVEDV).135.7 mLStandard Deviation 40.3
Secondary

Left Ventricular End-diastolic Volume (LVEDV).

Left Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-diastolic Volume (LVEDV).133.5 mLStandard Deviation 48.9
Secondary

Left Ventricular End-diastolic Volume (LVEDV).

Left Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 24 months

Population: Of 78 total population, 39 participants were included in the analysis population because of 26 deaths within 2 year, 7 withdrawals, 1 missed visit and LVEDV was not done or un-evaluable in 5 patients.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-diastolic Volume (LVEDV).136.3 mLStandard Deviation 37.8
Secondary

Left Ventricular End-diastolic Volume (LVEDV).

Left Ventricular End Diastolic Volume (LVEDV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-diastolic Volume (LVEDV).139.5 mLStandard Deviation 46.6
Secondary

Left Ventricular End-systolic Volume (LVESV).

Left Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 24 months

Population: Of 78 total population, 39 participants were included in the analysis population because of 26 deaths within 2 year, 7 withdrawals, 1 missed visit and LVESV was not done or un-evaluable in 5 patients.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-systolic Volume (LVESV).71.3 mLStandard Deviation 33.4
Secondary

Left Ventricular End-systolic Volume (LVESV).

Left Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-systolic Volume (LVESV).66.4 mLStandard Deviation 33.1
Secondary

Left Ventricular End-systolic Volume (LVESV).

Left Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-systolic Volume (LVESV).67.2 mLStandard Deviation 38
Secondary

Left Ventricular End-systolic Volume (LVESV).

Left Ventricular End Systolic Volume (LVESV) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular End-systolic Volume (LVESV).73.3 mLStandard Deviation 36.9
Secondary

Left Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)

Left Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 24 months

Population: Of 78 total population, 42 participants were included in the analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and LVIDd/LVIDs not done or un-evaluable in 2 patients.

ArmMeasureGroupValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Diastole (LVIDd)5.3 cmStandard Deviation 0.8
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Systole (LVIDs)4.0 cmStandard Deviation 1
Secondary

Left Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)

Left Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureGroupValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Diastole (LVIDd)5.5 cmStandard Deviation 0.8
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Systole (LVIDs)4.2 cmStandard Deviation 1
Secondary

Left Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)

Left Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureGroupValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Diastole (LVIDd)5.5 cmStandard Deviation 0.7
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Systole (LVIDs)4.0 cmStandard Deviation 1
Secondary

Left Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)

Left Ventricular Internal Dimension in diastole (LVIDd) and Left Ventricular Internal Dimension in systole (LVIDs) as determined by the core echocardiography laboratory from a transthoracic echocardiogram (TTE).

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureGroupValue (MEAN)Dispersion
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Diastole (LVIDd)5.4 cmStandard Deviation 0.8
High Risk Registry ArmLeft Ventricular Measurement: Left Ventricular Internal Dimension Diastole (LVIDd), Left Ventricular Internal Dimension Systole (LVIDs)LV Internal Diameter, Systole (LVIDs)4.1 cmStandard Deviation 1.1
Secondary

Mitral Valve Area: By Planimetry

Mitral valve area as measured by core lab echocardiography.

Time frame: 12 months

Population: Of 78 total population, 45 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 11 patients Mitral valve area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Planimetry3.0 cm^2Standard Deviation 1
Secondary

Mitral Valve Area: By Planimetry

Mitral valve area as measured by core lab echocardiography.

Time frame: 30 days

Population: Of 78 total population, 50 participants were included in analysis population because of 6 deaths and Mitral Valve Area by planimetry was not done in 22 patients.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Planimetry3.3 cm^2Standard Deviation 0.9
Secondary

Mitral Valve Area: By Planimetry

Mitral valve area as measured by core lab echocardiography.

Time frame: 36 months

Population: Of 78 total population, 25 participants were included in analysis population because of 31 deaths within 3 years, 7 withdrawals, 1 missed visit and in 14 patients mitral valve area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Planimetry2.9 cm^2Standard Deviation 0.8
Secondary

Mitral Valve Area: By Planimetry

Mitral valve area as measured by core lab echocardiography.

Time frame: 48 months

Population: Of 78 total population, 18 participants were included in analysis population because of 33 deaths within 4 years, 8 withdrawals, 3 missed visit and in 16 patients Mitral Valve Area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Planimetry3.0 cm^2Standard Deviation 0.7
Secondary

Mitral Valve Area: By Planimetry

Mitral valve area as measured by core lab echocardiography.

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Planimetry2.9 cm^2Standard Deviation 0.8
Secondary

Mitral Valve Area: By Planimetry

Mitral valve area as measured by core lab echocardiography.

Time frame: 24 months

Population: Of 78 total population, 19 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and in 25 patients Mitral valve area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Planimetry3.3 cm^2Standard Deviation 0.6
Secondary

Mitral Valve Area: By Pressure Half-time

Mitral valve area as measured by core lab echocardiography.

Time frame: 30 days

Population: Of 78 total population, 66 participants were included in analysis population because of 6 deaths and in 6 patients Mitral valve area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Pressure Half-time2.9 cm^2Standard Deviation 1.2
Secondary

Mitral Valve Area: By Pressure Half-time

Mitral valve area as measured by core lab echocardiography.

Time frame: 12 months

Population: Of 78 total population, 53 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 3 patients Mitral valve area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Pressure Half-time3.0 cm^2Standard Deviation 1.2
Secondary

Mitral Valve Area: By Pressure Half-time

Mitral valve area as measured by core lab echocardiography.

Time frame: 24 months

Population: Of 78 total population, 40 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and in 4 patients Mitral valve area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Pressure Half-time2.8 cm^2Standard Deviation 0.8
Secondary

Mitral Valve Area: By Pressure Half-time

Mitral valve area as measured by core lab echocardiography.

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Pressure Half-time2.9 cm^2Standard Deviation 0.8
Secondary

Mitral Valve Area: By Pressure Half-time

Mitral valve area as measured by core lab echocardiography.

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Pressure Half-time2.8 cm^2Standard Deviation 0.9
Secondary

Mitral Valve Area: By Pressure Half-time

Mitral valve area as measured by core lab echocardiography.

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area: By Pressure Half-time2.8 cm^2Standard Deviation 0.7
Secondary

Mitral Valve Area Index : By Planimetry

Mitral valve area as measured by core lab echocardiography by planimetry and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 30 days

Population: Of 78 total population, 50 participants were included in analysis population because of 6 deaths and Mitral Valve Area Index by planimetry was not done in 22 patients.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Planimetry1.7 cm^2/m^2Standard Deviation 0.5
Secondary

Mitral Valve Area Index : By Planimetry

Mitral valve area as measured by core lab echocardiography by planimetry and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 12 months

Population: Of 78 total population, 45 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 11 patients Mitral Valve Area evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Planimetry1.6 cm^2/m^2Standard Deviation 0.5
Secondary

Mitral Valve Area Index : By Planimetry

Mitral valve area as measured by core lab echocardiography by planimetry and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 24 months

Population: Of 78 total population, 19 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and in 25 patients Mitral Valve Area evaluation was not done or un-evaluable

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Planimetry1.7 cm^2/m^2Standard Deviation 0.3
Secondary

Mitral Valve Area Index : By Planimetry

Mitral valve area as measured by core lab echocardiography by planimetry and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Planimetry1.5 cm^2/m^2Standard Deviation 0.4
Secondary

Mitral Valve Area Index : By Planimetry

Mitral valve area as measured by core lab echocardiography by planimetry and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Planimetry1.5 cm^2/m^2Standard Deviation 0.4
Secondary

Mitral Valve Area Index : By Planimetry

Mitral valve area as measured by core lab echocardiography by planimetry and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Planimetry1.5 cm^2/m^2Standard Deviation 0.4
Secondary

Mitral Valve Area Index : By Pressure Half-time Formula

Mitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Pressure Half-time Formula1.5 cm^2/m^2Standard Deviation 0.5
Secondary

Mitral Valve Area Index : By Pressure Half-time Formula

Mitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 12 months

Population: Of 78 total population, 53 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 3 patients Mitral Valve Area evaluation was not done or un-evaluable

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Pressure Half-time Formula1.6 cm^2/m^2Standard Deviation 0.7
Secondary

Mitral Valve Area Index : By Pressure Half-time Formula

Mitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 24 months

Population: Of 78 total population, 40 participants were included in the analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and in 4 patients Mitral Valve Area evaluation was not done or un-evaluable

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Pressure Half-time Formula1.5 cm^2/m^2Standard Deviation 0.5
Secondary

Mitral Valve Area Index : By Pressure Half-time Formula

Mitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Pressure Half-time Formula1.5 cm^2/m^2Standard Deviation 0.5
Secondary

Mitral Valve Area Index : By Pressure Half-time Formula

Mitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\].

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area Index : By Pressure Half-time Formula1.5 cm^2/m^2Standard Deviation 0.4
Secondary

Mitral Valve Area (MVA) Index: by Pressure-Half Time Formula

Mitral valve area as measured by core lab echocardiography using the pressure half-time formula and indexed to Body surface area (BSA). \[MVA Index = MVA (cm\^2)/BSA (m\^2)\]

Time frame: 30 days

Population: Of 78 total population, 65 participants were included in analysis population because of 6 deaths and Mitral Valve Area Index by pressure half-time was not done in 7 patients.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Area (MVA) Index: by Pressure-Half Time Formula1.6 cm^2/m^2Standard Deviation 0.7
Secondary

Mitral Valve Index

Mitral valve area as measured by core lab echocardiography and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\]

Time frame: 12 months

Population: Of 78 total population, 45 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 11 patients Mitral valve index evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Index1.6 cm^2/m^2Standard Deviation 0.5
Secondary

Mitral Valve Index

Mitral valve area as measured by core lab echocardiography and indexed to body surface area \[MVA Index = MVA (cm\^2)/BSA (m\^2)\]

Time frame: 30 days

Population: Of 78 total population, 50 participants were included in the analysis population because of 6 deaths within 30 days and in 22 participants Mitral valve index was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmMitral Valve Index1.7 cm^2/m^2Standard Deviation 0.5
Secondary

Number of Days Re-hospitalized for CHF

Defined as the number of days hospitalized for CHF in the 12-months prior to the Clip implant procedure date compared to the number of days re-hospitalized for CHF in the 12-months after Clip implant.

Time frame: 12 months

Population: 12/75 hospitalized for CHF post-discharge, representing 22 separate hospitalization events with mean of 6.6+/-3.7 days.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmNumber of Days Re-hospitalized for CHF6.6 daysStandard Deviation 3.7
Secondary

Number of Hospital Re-Admissions for Congestive Heart Failure (CHF)

Defined as the number of hospital admissions (i.e. events) for which the primary diagnosis for hospitalization is congestive heart failure, in the 12-months post-discharge following the MitraClip procedure.

Time frame: 12 months

Population: Of 78 patients, 3 patients who died prior to discharge were not included.

ArmMeasureValue (NUMBER)
High Risk Registry ArmNumber of Hospital Re-Admissions for Congestive Heart Failure (CHF)22 Events
Secondary

Number of Participants Discharged to a Nursing Home or Skilled Nursing Facility or Hospital

Discharge to a nursing home or skilled nursing facility following discharge from the hospital after definitive treatment.

Time frame: 30 Days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants Discharged to a Nursing Home or Skilled Nursing Facility or Hospital6 Participants
Secondary

Number of Participants Experiencing Major Adverse Events

Combined clinical endpoint of death, myocardial infarction, reoperation for failed surgical repair or replacement, nonelective cardiovascular surgery for adverse events, stroke, renal failure, deep wound infection, ventilation for greater than 48 hours, GI complication requiring surgery, new onset of permanent atrial fibrillation, septicemia, and transfusion of 2 or more units of blood.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants Experiencing Major Adverse Events33 Participants
Secondary

Number of Participants Experiencing Major Adverse Events (MAE)

Combined clinical endpoint of death, myocardial infarction, reoperation for failed surgical repair or replacement, nonelective cardiovascular surgery for adverse events, stroke, renal failure, deep wound infection, ventilation for greater than 48 hours, GI complication requiring surgery, new onset of permanent atrial fibrillation, septicemia, and transfusion of 2 or more units of blood.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants Experiencing Major Adverse Events (MAE)21 Participants
Secondary

Number of Participants Experiencing Major Vascular Complications

Defined as the occurrence of any of the following resulting from the index procedure: * Hematoma at access site \>6 cm; * Retroperitoneal hematoma; * Arterial-venous fistula; * Symptomatic peripheral ischemia/ nerve injury with clinical signs or symptoms lasting \>24 hours; * Vascular surgical repair at catheter access sites; * Pulmonary embolism; * Ipsilateral deep vein thrombus; or * Access site-related infection requiring intravenous antibiotics and/or extended hospitalization.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants Experiencing Major Vascular Complications3 Participants
Secondary

Number of Participants Experiencing Major Vascular Complications

Defined as the occurrence of any of the following resulting from the index procedure: * Hematoma at access site \>6 cm; * Retroperitoneal hematoma; * Arterial-venous fistula; * Symptomatic peripheral ischemia/ nerve injury with clinical signs or symptoms lasting \>24 hours; * Vascular surgical repair at catheter access sites; * Pulmonary embolism; * Ipsilateral deep vein thrombus; or * Access site-related infection requiring intravenous antibiotics and/or extended hospitalization.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants Experiencing Major Vascular Complications2 Participants
Secondary

Number of Participants Over 75 Years of Age With MAE

Combined clinical endpoint of death, myocardial infarction, reoperation for failed surgical repair or replacement, nonelective cardiovascular surgery for adverse events, stroke, renal failure, deep wound infection, ventilation for greater than 48 hours, GI complication requiring surgery, new onset of permanent atrial fibrillation, septicemia, and transfusion of 2 or more units of blood.

Time frame: 12 months

Population: Analysis population includes 48 patients who were aged 75 years or older in the study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants Over 75 Years of Age With MAE23 Participants
Secondary

Number of Participants Over 75 Years of Age With MAE

Combined clinical endpoint of death, myocardial infarction, reoperation for failed surgical repair or replacement, nonelective cardiovascular surgery for adverse events, stroke, renal failure, deep wound infection, ventilation for greater than 48 hours, GI complication requiring surgery, new onset of permanent atrial fibrillation, septicemia, and transfusion of 2 or more units of blood.

Time frame: 30 days

Population: Analysis population includes 48 patients who were aged 75 years or older in the study.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants Over 75 Years of Age With MAE14 Participants
Secondary

Number of Participants With Atrial Septal Defect (ASD)

Occurrence of clinically significant ASD as a result of the procedure requiring intervention.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Atrial Septal Defect (ASD)2 Participants
Secondary

Number of Participants With Atrial Septal Defect (ASD)

Occurrence of clinically significant ASD as a result of the procedure requiring intervention.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Atrial Septal Defect (ASD)2 Participants
Secondary

Number of Participants With Clinical Durability

Proportion of patients who have an acute reduction in MR severity of at least one grade (as measured by the discharge echocardiogram) that have not required surgery for valve dysfunction and meet either of the following: 1) MR severity grade of 2+ or less or 2) a one grade reduction in MR severity compared to baseline accompanied by at least a one level reduction in NYHA.

Time frame: 24 months

Population: Through 24 months, the clinical durability status of 3 patients is unknown and there were 35 patients with an acute reduction in MR severity from baseline of at least one grade (the one patient who underwent surgery between 12 months and 24 months is not included in the 35 patients).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Clinical Durability35 Participants
Secondary

Number of Participants With Clinical Durability

Proportion of patients who have an acute reduction in MR severity of at least one grade (as measured by the discharge echocardiogram) that have not required surgery for valve dysfunction and meet either of the following: 1) MR severity grade of 2+ or less or 2) a one grade reduction in MR severity compared to baseline accompanied by at least a one level reduction in NYHA.

Time frame: 12 months

Population: There were 62 patients with an acute reduction in MR severity of at least one grade, and of these, 43 patients met the criterion for clinical durability. The clinical durability rate is therefore 43/62, or 69.4%.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Clinical Durability43 Participants
Secondary

Number of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) Class

Class I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

Time frame: 48 months

Population: Of 78 total population, 31 participants were included in the analysis population because of 33 deaths within 3 years, 8 withdrawals, 3 missed visit and NYHA was not assessed in 3 patients.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class I8 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class II20 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class III3 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class IV0 Participants
Secondary

Number of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) Class

Class I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

Time frame: 24 months

Population: Of 78 total population, 43 participants were included in the analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and 1 patient without NYHA Class assessment.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class I13 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class II24 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class III5 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class IV1 Participants
Secondary

Number of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) Class

Class I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

Time frame: 36 months

Population: Of 78 total population, 37 participants were included in analysis population because of 31 deaths within 3 years, 7 withdrawals, 1 missed visit and 2 patients without NYHA Class assessment.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class I10 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class II20 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class III7 Participants
High Risk Registry ArmNumber of Participants With Composite Functional and Structural Measures - Clinical Measures of Benefit-New York Heart Association (NYHA) ClassNYHA Functional Class IV0 Participants
Secondary

Number of Participants With Device Embolization or Single Leaflet Device Attachment

Device embolization is defined as bilateral Clip detachment resulting in Clip embolization. Reasons for Clip embolization include leaflet tearing, Clip unlocking, Clip fracture or inadequate Clip placement (i.e., malposition). Not included are any fractures or other failures of the Clip that do not result in Clip detachment from both leaflets. A single leaflet device attachment (SLDA) is defined as attachment of one mitral valve leaflet to the MitraClip device.

Time frame: 0 to 12 months

Population: Three patients were excluded from the analysis as they did not receive a Device.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentDevice Embolization0 Participants
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentSingle Leaflet Device Attachment1 Participants
Secondary

Number of Participants With Device Embolization or Single Leaflet Device Attachment

Device embolization is defined as bilateral Clip detachment resulting in Clip embolization. Reasons for Clip embolization include leaflet tearing, Clip unlocking, Clip fracture or inadequate Clip placement (i.e., malposition). Not included are any fractures or other failures of the Clip that do not result in Clip detachment from both leaflets. A single leaflet device attachment (SLDA) is defined as attachment of one mitral valve leaflet to the MitraClip device.

Time frame: 48 months

Population: Patients implanted with a MitraClip device and alive were evaluated at 48 months.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentDevice Embolization0 Participants
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentSingle Leaflet Device Attachment0 Participants
Secondary

Number of Participants With Device Embolization or Single Leaflet Device Attachment

Device embolization is defined as bilateral Clip detachment resulting in Clip embolization. Reasons for Clip embolization include leaflet tearing, Clip unlocking, Clip fracture or inadequate Clip placement (i.e., malposition). Not included are any fractures or other failures of the Clip that do not result in Clip detachment from both leaflets. A single leaflet device attachment (SLDA) is defined as attachment of one mitral valve leaflet to the MitraClip device.

Time frame: 36 months

Population: Patients implanted with a MitraClip device, alive were evaluated at 36 months.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentDevice Embolization0 Participants
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentSingle Leaflet Device Attachment0 Participants
Secondary

Number of Participants With Device Embolization or Single Leaflet Device Attachment

Device embolization is defined as bilateral Clip detachment resulting in Clip embolization. Reasons for Clip embolization include leaflet tearing, Clip unlocking, Clip fracture or inadequate Clip placement (i.e., malposition). Not included are any fractures or other failures of the Clip that do not result in Clip detachment from both leaflets. A single leaflet device attachment (SLDA) is defined as attachment of one mitral valve leaflet to the MitraClip device.

Time frame: 60 months

Population: Patients implanted with a MitraClip device and alive were evaluated at 60 months.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentDevice Embolization0 Participants
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentSingle Leaflet Device Attachment0 Participants
Secondary

Number of Participants With Device Embolization or Single Leaflet Device Attachment

Device embolization is defined as bilateral Clip detachment resulting in Clip embolization. Reasons for Clip embolization include leaflet tearing, Clip unlocking, Clip fracture or inadequate Clip placement (i.e., malposition). Not included are any fractures or other failures of the Clip that do not result in Clip detachment from both leaflets. A single leaflet device attachment (SLDA) is defined as attachment of one mitral valve leaflet to the MitraClip device.

Time frame: 24 months

Population: Patients implanted with a MitraClip device, alive were evaluated at 24 months.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentDevice Embolization0 Participants
High Risk Registry ArmNumber of Participants With Device Embolization or Single Leaflet Device AttachmentSingle Leaflet Device Attachment0 Participants
Secondary

Number of Participants With Dysrhythmias

Includes all new onset atrial fibrillation and heart block requiring placement of a permanent pacemaker.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Dysrhythmias8 Participants
Secondary

Number of Participants With Dysrhythmias

Includes all new onset atrial fibrillation and heart block requiring placement of a permanent pacemaker.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Dysrhythmias5 Participants
Secondary

Number of Participants With Endocarditis

Using Duke Criteria, endocarditis can be confirmed by: Pathological criteria: Endocarditis is confirmed if microorganisms are identified by culture or histology in a vegetation, embolized vegetation, or an intracardiac abscess; or if pathological lesions are observed & histologically confirmed showing active endocarditis. Clinical criteria: Endocarditis is confirmed by the presence of 2 major criteria, 1 major plus 3 minor criteria, or 5 minor criteria. Major criteria include persistently +ve blood cultures with the presence of typical organisms for endocarditis; persistent bacteremia; evidence of endocardial involvement with positive echocardiogram with signs of oscillating vegetation, abscesses, valve perforation, new partial dehiscence of prosthetic valve or new valvular regurgitation. Minor criteria include predisposing heart condition, fever, vascular phenomena, immunologic phenomena, & positive blood culture or echocardiogram not meeting major criteria.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Endocarditis1 Participants
Secondary

Number of Participants With Endocarditis

Using Duke Criteria, endocarditis can be confirmed by: Pathological criteria: Endocarditis is confirmed if microorganisms are identified by culture or histology in a vegetation, embolized vegetation, or an intracardiac abscess; or if pathological lesions are observed & histologically confirmed showing active endocarditis. Clinical criteria: Endocarditis is confirmed by the presence of 2 major criteria, 1 major plus 3 minor criteria, or 5 minor criteria. Major criteria include persistently +ve blood cultures with the presence of typical organisms for endocarditis; persistent bacteremia; evidence of endocardial involvement with positive echocardiogram with signs of oscillating vegetation, abscesses, valve perforation, new partial dehiscence of prosthetic valve or new valvular regurgitation. Minor criteria include predisposing heart condition, fever, vascular phenomena, immunologic phenomena, & positive blood culture or echocardiogram not meeting major criteria.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Endocarditis0 Participants
Secondary

Number of Participants With Hemolysis

Defined as new onset of anemia associated with laboratory evidence of red cell destruction. Diagnosed when plasma free hemoglobin is greater than 40 mg/dL on two measures within 24 hours or on one measure if intervention is initiated based on other clinical symptoms

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Hemolysis0 Participants
Secondary

Number of Participants With Hemolysis

Defined as new onset of anemia associated with laboratory evidence of red cell destruction. Diagnosed when plasma free hemoglobin is greater than 40 mg/dL on two measures within 24 hours or on one measure if intervention is initiated based on other clinical symptoms.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Hemolysis0 Participants
Secondary

Number of Participants With High Risk Procedural Success

Successful implantation of the Clip (s) with resulting MR severity of 2+ of less at discharge or a 1 grade MR reduction at discharge accompanied by a 1 level reduction in NYHA.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With High Risk Procedural Success60 Participants
Secondary

Number of Participants With Major Bleeding Complications

Defined as procedure related bleeding that requires a transfusion of ≥2 units of blood and/or surgical intervention.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Major Bleeding Complications15 Participants
Secondary

Number of Participants With Major Bleeding Complications

Defined as procedure related bleeding that requires a transfusion of ≥2 units of blood and/or surgical intervention.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Major Bleeding Complications13 Participants
Secondary

Number of Participants With Mitral Valve Repair Success

Freedom from mitral valve replacement surgery for Valve Dysfunction, death, re-operation, and MR \> 2+.

Time frame: 24 months

Population: Three Acute Procedural Success (APS) patients withdrew at or before 12 months, and had MR ≤ 2+ at all visits prior to withdrawal. Since there is no data on these patients post-12 months, these patients are not included in the endpoint of freedom from mitral valve replacement surgery for Valve Dysfunction, death and MR \> 2+ at 24 months.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Repair Success37 Participants
Secondary

Number of Participants With Mitral Valve Repair Success

Mitral Valve Repair Success defined as freedom from mitral valve replacement surgery for valve dysfunction, death, re-operation and MR \> 2+ at 12 months.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Repair Success44 Participants
Secondary

Number of Participants With Mitral Valve Replacement

Defined as how often patients receiving surgery required replacement of the mitral valve.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Replacement2 Participants
Secondary

Number of Participants With Mitral Valve Replacement

Defined as how often patients receiving surgery required replacement of the mitral valve.

Time frame: 24 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Replacement1 Participants
Secondary

Number of Participants With Mitral Valve Replacement

Defined as how often patients receiving surgery required replacement of the mitral valve.

Time frame: 36 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Replacement2 Participants
Secondary

Number of Participants With Mitral Valve Replacement

Defined as how often patients receiving surgery required replacement of the mitral valve.

Time frame: 48 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Replacement2 Participants
Secondary

Number of Participants With Mitral Valve Stenosis

Mitral stenosis associated with a total mitral valve orifice area less than 1.5 cm2.

Time frame: 12 months

Population: Of total 78 participants, only 72 participants were analyzed because 3 patients were not implanted with a device and 3 patients died prior to discharge.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Stenosis0 Participants
Secondary

Number of Participants With Mitral Valve Stenosis

Mitral stenosis associated with a total mitral valve orifice area less than 1.5 cm2.

Time frame: 24 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Stenosis2 Participants
Secondary

Number of Participants With Mitral Valve Stenosis

Mitral stenosis associated with a total mitral valve orifice area less than 1.5 cm2.

Time frame: 36 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Stenosis2 Participants
Secondary

Number of Participants With Mitral Valve Stenosis

Mitral stenosis associated with a total mitral valve orifice area less than 1.5 cm2.

Time frame: 48 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Stenosis2 Participants
Secondary

Number of Participants With Mitral Valve Stenosis

Mitral stenosis associated with a total mitral valve orifice area less than 1.5 cm2.

Time frame: 30 days

Population: Of total 78 participants, only 72 participants were analyzed as 6 deaths within 30 days.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Stenosis0 Participants
Secondary

Number of Participants With Mitral Valve Surgery Post-MitraClip Procedure

Number of patients who underwent surgical mitral valve repair or replacement after the index MitraClip procedure.

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Mitral Valve Surgery Post-MitraClip Procedure2 Participants
Secondary

Number of Participants With MR Severity

MR Severity: Site-assessed mitral regurgitation severity using echocardiography. MR severity is graded on a scale of 0+ to 4+ where 0+ means absence of mitral regurgitation, 1+ is mild, 1+ to 2+ is mild-to-moderate, 2+ to 3+ is moderate to moderate-to-Severe, 3+ is moderate-to-severe, 3+ to 4+ is moderate-to-severe to severe, 4+ is severe.

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With MR Severity2+: Moderate6 Participants
High Risk Registry ArmNumber of Participants With MR Severity0+: None0 Participants
High Risk Registry ArmNumber of Participants With MR Severity1+: Mild12 Participants
High Risk Registry ArmNumber of Participants With MR Severity3+: Moderate to Severe6 Participants
High Risk Registry ArmNumber of Participants With MR Severity4+: Severe0 Participants
Secondary

Number of Participants With MR Severity

MR Severity: Site-assessed mitral regurgitation severity using echocardiography. MR severity is graded on a scale of 0+ to 4+ where 0+ means absence of mitral regurgitation, 1+ is mild, 1+ to 2+ is mild-to-moderate, 2+ to 3+ is moderate to moderate-to-Severe, 3+ is moderate-to-severe, 3+ to 4+ is moderate-to-severe to severe, 4+ is severe.

Time frame: Discharge or 30 days

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With MR Severity0 : None0 Participants
High Risk Registry ArmNumber of Participants With MR Severity1+: Mild30 Participants
High Risk Registry ArmNumber of Participants With MR Severity2+: Moderate26 Participants
High Risk Registry ArmNumber of Participants With MR Severity3+: Moderate to Severe14 Participants
High Risk Registry ArmNumber of Participants With MR Severity4+: Severe6 Participants
Secondary

Number of Participants With MR Severity

MR Severity: Site-assessed mitral regurgitation severity using echocardiography. MR severity is graded on a scale of 0+ to 4+ where 0+ means absence of mitral regurgitation, 1+ is mild, 1+ to 2+ is mild-to-moderate, 2+ to 3+ is moderate to moderate-to-Severe, 3+ is moderate-to-severe, 3+ to 4+ is moderate-to-severe to severe, 4+ is severe.

Time frame: 12 months

Population: Of 78 total population, 54 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and MR Severity not done or un-evaluable in 2 patients.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With MR Severity0+: None0 Participants
High Risk Registry ArmNumber of Participants With MR Severity1+: Mild17 Participants
High Risk Registry ArmNumber of Participants With MR Severity2+: Moderate25 Participants
High Risk Registry ArmNumber of Participants With MR Severity3+: Moderate to Severe9 Participants
High Risk Registry ArmNumber of Participants With MR Severity4+: Severe3 Participants
Secondary

Number of Participants With MR Severity

MR Severity: Site-assessed mitral regurgitation severity using echocardiography. MR severity is graded on a scale of 0+ to 4+ where 0+ means absence of mitral regurgitation, 1+ is mild, 1+ to 2+ is mild-to-moderate, 2+ to 3+ is moderate to moderate-to-Severe, 3+ is moderate-to-severe, 3+ to 4+ is moderate-to-severe to severe, 4+ is severe.

Time frame: 24 months

Population: Of 78 total population, 42 participants were included in the analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and MR severity not assessed in 2 patients.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With MR Severity0+: None0 Participants
High Risk Registry ArmNumber of Participants With MR Severity1+: Mild14 Participants
High Risk Registry ArmNumber of Participants With MR Severity2+: Moderate23 Participants
High Risk Registry ArmNumber of Participants With MR Severity3+: Moderate to Severe5 Participants
High Risk Registry ArmNumber of Participants With MR Severity4+: Severe0 Participants
Secondary

Number of Participants With MR Severity

MR Severity: Site-assessed mitral regurgitation severity using echocardiography. MR severity is graded on a scale of 0+ to 4+ where 0+ means absence of mitral regurgitation, 1+ is mild, 1+ to 2+ is mild-to-moderate, 2+ to 3+ is moderate to moderate-to-Severe, 3+ is moderate-to-severe, 3+ to 4+ is moderate-to-severe to severe, 4+ is severe.

Time frame: 36 months

Population: Of 78 total population, 37 participants were included in the analysis population because of 31 deaths within 3 years, 7 withdrawals, 1 missed visit and MR Severity was not done or un-evaluable in 2 patients.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With MR Severity0+: None0 Participants
High Risk Registry ArmNumber of Participants With MR Severity1+: Mild16 Participants
High Risk Registry ArmNumber of Participants With MR Severity2+: Moderate16 Participants
High Risk Registry ArmNumber of Participants With MR Severity3+: Moderate to Severe5 Participants
High Risk Registry ArmNumber of Participants With MR Severity4+: Severe0 Participants
Secondary

Number of Participants With MR Severity

MR Severity: Site-assessed mitral regurgitation severity using echocardiography. MR severity is graded on a scale of 0+ to 4+ where 0+ means absence of mitral regurgitation, 1+ is mild, 1+ to 2+ is mild-to-moderate, 2+ to 3+ is moderate to moderate-to-Severe, 3+ is moderate-to-severe, 3+ to 4+ is moderate-to-severe to severe, 4+ is severe.

Time frame: 48 months

Population: Of 78 total population, 31 participants were included in the analysis population because of 33 deaths within 3 years, 8 withdrawals, 3 missed visit and MR severity was not done or un-evaluable in 3 patients.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With MR Severity0+: None0 Participants
High Risk Registry ArmNumber of Participants With MR Severity1+: Mild18 Participants
High Risk Registry ArmNumber of Participants With MR Severity2+: Moderate9 Participants
High Risk Registry ArmNumber of Participants With MR Severity3+: Moderate to Severe3 Participants
High Risk Registry ArmNumber of Participants With MR Severity4+: Severe1 Participants
Secondary

Number of Participants With New Coumadin Use

New onset use of Coumadin or warfarin to treat a potential thrombus on a defibrillator lead.

Time frame: 6 months

Population: 49 patients not on coumadin at baseline are included in the analysis.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With New Coumadin Use11 Participants
Secondary

Number of Participants With New Coumadin Use

New onset use of Coumadin or warfarin to treat a potential thrombus on a defibrillator lead.

Time frame: 12 months

Population: 49 patients not on coumadin at baseline are included in the analysis.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With New Coumadin Use12 Participants
Secondary

Number of Participants With New Coumadin Use

New onset use of Coumadin or warfarin to treat a potential thrombus on a defibrillator lead.

Time frame: 30 days

Population: 49 patients not on coumadin at baseline are included in the analysis.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With New Coumadin Use9 Participants
Secondary

Number of Participants With New York Heart Association (NYHA) Class

Class I: Patients with cardiac disease but without resulting limitations of physical activity. Class II: Patients with cardiac disease resulting in slight limitation of physical activity. Patients are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain. Class III: Patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary physical activity causes fatigue, palpitation dyspnea, or anginal pain. Class IV: Patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms of cardiac insufficiency or of the anginal syndrome may be present even at rest. If any physical activity is undertaken, discomfort is increased.

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class I6 Participants
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class II14 Participants
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class III4 Participants
High Risk Registry ArmNumber of Participants With New York Heart Association (NYHA) ClassNYHA Functional Class IV0 Participants
Secondary

Number of Participants With Non-cerebral Thromboembolism

Defined as any mural thrombus or thromboembolism in the vasculature (excluding central nervous system events) confirmed by standard clinical and laboratory testing and which requires intervention.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Non-cerebral Thromboembolism0 Participants
Secondary

Number of Participants With Non-cerebral Thromboembolism

Defined as any mural thrombus or thromboembolism in the vasculature (excluding central nervous system events) confirmed by standard clinical and laboratory testing and which requires intervention.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Non-cerebral Thromboembolism1 Participants
Secondary

Number of Participants With Second MitraClip Device Implanted

It is a summary of re-interventions to place an additional MitraClip Device.

Time frame: 0 to 5 years

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Second MitraClip Device Implanted2 Participants
Secondary

Number of Participants With Successful Clip Implant

Rate of successful delivery and deployment of Clip implants with echocardiographic evidence of leaflet approximation and retrieval of the investigational delivery catheter.

Time frame: 30 Days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Successful Clip Implant74 Participants
Secondary

Number of Participants With Thrombosis

Evidence of formation of an independently moving thrombus on any part of the Clip or any commercially available implant used during surgery by echocardiography or fluoroscopy. If Clip is explanted or an autopsy is performed this diagnosis should be confirmed.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Thrombosis0 Participants
Secondary

Number of Participants With Thrombosis

Evidence of formation of an independently moving thrombus on any part of the Clip or any commercially available implant used during surgery by echocardiography or fluoroscopy. If Clip is explanted or an autopsy is performed this diagnosis should be confirmed.

Time frame: 30 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Thrombosis0 Participants
Secondary

Number of Participants With Treatment Durability

Defined as the proportion of Acute Procedural Success patients with MR severity grade of 2+ or less that have not required surgery for valve dysfunction.

Time frame: 12 months

Population: Of 78 total population, 56 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals and 1 missed visit.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Treatment Durability39 Participants
Secondary

Number of Participants With Treatment Durability

Defined as the proportion of Acute Procedural Success patients with MR severity grade of 2+ or less that have not required surgery for valve dysfunction.

Time frame: 24 months

Population: At 24 months, of the 56 patients who achieved acute procedural success, the status of 3 patients is unknown. Among the remaining 53 patients, 30 patients (56.6%) were alive and free from MR \> 2+ at 24 months.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
High Risk Registry ArmNumber of Participants With Treatment Durability30 Participants
Secondary

Percentage of Participants With Composite Functional and Structural Measures - Freedom From Death and MR >2+

Kaplan-Meier estimated proportion of patients who are alive and have a mitral regurgitation severity grade of 2+ or less.

Time frame: 24 months

Population: Primary Analysis at 24 months included only 75 patients. Three patients were excluded due to withdrawal at or before 12 months.

ArmMeasureGroupValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Composite Functional and Structural Measures - Freedom From Death and MR >2+Primary Analysis49.3 percentage of participants
High Risk Registry ArmPercentage of Participants With Composite Functional and Structural Measures - Freedom From Death and MR >2+Worstcase Analysis46.2 percentage of participants
Secondary

Percentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery

Kaplan-Meier estimate of the percentage of patients who are alive and did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery41.2 percentage of participants
Secondary

Percentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery

Kaplan-Meier estimate of the percentage of patients who are alive and did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 12 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery75.6 percentage of participants
Secondary

Percentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery

Kaplan-Meier estimate of the percentage of patients who are alive and did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 24 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery63.2 percentage of participants
Secondary

Percentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery

Kaplan-Meier estimate of the percentage of patients who are alive and did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 36 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery57.4 percentage of participants
Secondary

Percentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery

Kaplan-Meier estimate of the percentage of patients who are alive and did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 48 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From All-Cause Mortality and Mitral Valve Surgery51.5 percentage of participants
Secondary

Percentage of Participants With Freedom From Mitral Valve Surgery

Percentage of patients who did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 48 months

Population: Analysis population includes 35 participants, which represents the number of patients at risk as per Kaplan-Meier analysis at 48 months.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From Mitral Valve Surgery95.5 percentage of participants
Secondary

Percentage of Participants With Freedom From Mitral Valve Surgery

Percentage of patients who did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: Baseline

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From Mitral Valve Surgery100 percentage of participants
Secondary

Percentage of Participants With Freedom From Mitral Valve Surgery

Percentage of patients who did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 36 months

Population: Analysis population includes 39 participants, which represents the number of patients at risk as per Kaplan-Meier analysis at 36 months.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From Mitral Valve Surgery98.1 percentage of participants
Secondary

Percentage of Participants With Freedom From Mitral Valve Surgery

Percentage of patients who did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 60 months

Population: Analysis population includes 14 participants, which represents the number of patients at risk as per Kaplan-Meier analysis at 60 months.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From Mitral Valve Surgery95.5 percentage of participants
Secondary

Percentage of Participants With Freedom From Mitral Valve Surgery

Percentage of patients who did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 12 months

Population: Analysis population includes 58 participants, which represents the number of patients at risk as per Kaplan-Meier freedom from Mitral valve (MV)surgery analysis at 12 months.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From Mitral Valve Surgery100 percentage of participants
Secondary

Percentage of Participants With Freedom From Mitral Valve Surgery

Percentage of patients who did not undergo surgical mitral valve repair or replacement after the index MitraClip procedure

Time frame: 24 months

Population: Analysis population includes 45 participants, which represents the number of patients at risk as per Kaplan-Meier analysis at 24 months.

ArmMeasureValue (NUMBER)
High Risk Registry ArmPercentage of Participants With Freedom From Mitral Valve Surgery98.1 percentage of participants
Secondary

Post-procedure Intensive Care Unit (ICU)/ Critical Care Unit (CCU) Time

Number of hours patients are in an intensive care unit or step down unit before discharge or moving to a standard care unit.

Time frame: Length of ICU/CCU stay, assessed at 30 Days

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmPost-procedure Intensive Care Unit (ICU)/ Critical Care Unit (CCU) Time52.3 hoursStandard Deviation 80.6
Secondary

Post-procedure Length of Hospital Stay

Defined as the number of days from the end of the procedure until the patient is discharged from the hospital. This does not include time in a nursing or skilled care facility.

Time frame: Length of Hospital Stay, assessed at 30 days

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmPost-procedure Length of Hospital Stay3.9 daysStandard Deviation 6.4
Secondary

Procedural Freedom From In-hospital MAE

Percutaneous Clip procedure or surgery with no occurrence of in-hospital MAE.

Time frame: 30 Days

ArmMeasureValue (NUMBER)
High Risk Registry ArmProcedural Freedom From In-hospital MAE61 participants
Secondary

Regurgitant Fraction

RF is defined as the percentage of the left ventricular (LV) stroke volume that regurgitates into the left atrium.

Time frame: 24 months

Population: Of 78 total population, 26 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and 18 patients were without Regurgitant fraction assessment.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmRegurgitant Fraction27.4 percentage of LV stroke volumeStandard Deviation 13
Secondary

Regurgitant Fraction

RF is defined as the percentage of the left ventricular (LV) stroke volume that regurgitates into the left atrium.

Time frame: 12 months

Population: Of 78 total population, 44 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 6 patients Regurgitant fraction evaluation was not done or not evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmRegurgitant Fraction26.3 percentage of LV stroke volumeStandard Deviation 16.5
Secondary

Regurgitant Fraction (RF)

RF is defined as the percentage of the left ventricular (LV) stroke volume that regurgitates into the left atrium.

Time frame: 30 days

Population: Of 78 total population, 58 participants were analysed as 6 participants died within 30 days and 14 missing data (not done or not evaluable).

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmRegurgitant Fraction (RF)32.1 percentage of LV stroke volumeStandard Deviation 15.2
Secondary

Regurgitant Volume

Regurgitant volume as measured by the core echocardiographic laboratory at follow-up.

Time frame: 12 months

Population: Of 78 total population, 44 participants were included in the analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 6 patients Regurgitant volume evaluation was not done or not evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmRegurgitant Volume20.4 mLStandard Deviation 15.4
Secondary

Regurgitant Volume

Regurgitant volume as measured by the core echocardiographic laboratory at follow-up.

Time frame: 30 days

Population: Of 78 total population, 58 participants were included in the analysis population because of 6 deaths within 30 days and 14 missing data (not done or not evaluable).

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmRegurgitant Volume25.2 mLStandard Deviation 14.4
Secondary

Regurgitant Volume

Regurgitant volume as measured by the core echocardiographic laboratory at follow-up.

Time frame: 24 months

Population: Of 78 total population, 26 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and 18 patients were without Regurgitant Volume assessment.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmRegurgitant Volume19.9 mLStandard Deviation 10.7
Secondary

Transvalvular Mitral Valve Gradient

Defined as the mean pressure gradients across the mitral valve as measured by echocardiography.

Time frame: 30 days

Population: Of 78 total population, 69 participants were included in the analysis population because of 6 deaths within 30 days and in 3 participants Mitral Valve Gradient was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmTransvalvular Mitral Valve Gradient3.9 mmHgStandard Deviation 2.6
Secondary

Transvalvular Mitral Valve Gradient

Defined as the mean pressure gradients across the mitral valve as measured by echocardiography.

Time frame: 48 months

Population: Of 78 total population, 31 participants were included in analysis population because of 31 deaths within 3 years, 7 withdrawals, 1 missed visit and in 8 patients Mitral Valve Gradient evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmTransvalvular Mitral Valve Gradient3.6 mmHgStandard Deviation 1.8
Secondary

Transvalvular Mitral Valve Gradient

Defined as the mean pressure gradients across the mitral valve as measured by echocardiography.

Time frame: 36 months

Population: Of 78 total population, 36 participants were included in analysis population because of 31 deaths within 2 years, 7 withdrawals, 1 missed visit and in 3 patients Mitral Valve Gradient evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmTransvalvular Mitral Valve Gradient3.8 mmHgStandard Deviation 2.7
Secondary

Transvalvular Mitral Valve Gradient

Defined as the mean pressure gradients across the mitral valve as measured by echocardiography.

Time frame: 24 months

Population: Of 78 total population, 40 participants were included in analysis population because of 26 deaths within 2 years, 7 withdrawals, 1 missed visit and in 4 patients Mitral Valve Gradient evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmTransvalvular Mitral Valve Gradient3.2 mmHgStandard Deviation 1.9
Secondary

Transvalvular Mitral Valve Gradient

Defined as the mean pressure gradients across the mitral valve as measured by echocardiography.

Time frame: 12 months

Population: Of 78 total population, 53 participants were included in analysis population because of 18 deaths within 1 year, 3 withdrawals, 1 missed visit and in 3 patients Mitral Valve Gradient evaluation was not done or un-evaluable.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmTransvalvular Mitral Valve Gradient3.6 mmHgStandard Deviation 2.9
Secondary

Transvalvular Mitral Valve Gradient

Defined as the mean pressure gradients across the mitral valve as measured by echocardiography.

Time frame: 60 months

Population: The number of participants analyzed includes subjects who had available follow up data at that time frame.

ArmMeasureValue (MEAN)Dispersion
High Risk Registry ArmTransvalvular Mitral Valve Gradient3.8 mmHgStandard Deviation 2

Source: ClinicalTrials.gov · Data processed: Mar 5, 2026