Association of Hypertrophic Cardiomyopathy and Outcomes After Transcatheter Edge-to-Edge Mitral Valve Repair

Many patients with hypertrophic cardiomyopathy (HC) have concomitant mitral valve disease, with systolic anterior motion of the mitral valve apparatus and resultant mitral regurgitation. These patients are often at an increased risk for progressive heart failure, supraventricular and ventricular arrhythmias, and sudden cardiac death. 1 Thomas F Rader F Siegel RJ. The use of MitraClip for symptomatic patients with hypertrophic obstructive cardiomyopathy. Cardiology. 2017; 137: 58-61 Crossref PubMed Scopus (25) Google Scholar In addition to the nonpharmacologic therapies for symptomatic patients with HC, including septal myectomy and alcohol septal ablation (ASA), few studies have evaluated the utility of transcatheter edge-to-edge mitral valve repair (TMVr) with MitraClip in patients with HC. 2 Long A Mahoney P. Use of MitraClip to target obstructive SAM in severe diffuse-type hypertrophic cardiomyopathy: case report and review of literature. J Invasive Cardiol. 2020; 32: E228-E232 PubMed Google Scholar , 3 Schäfer U Frerker C Thielsen T Schewel D Bader R Kuck KH Kreidel F. Targeting systolic anterior motion and left ventricular outflow tract obstruction in hypertrophic obstructed cardiomyopathy with a MitraClip. EuroIntervention. 2015; 11: 942-947 Crossref PubMed Scopus (39) Google Scholar , 4 Wong N Hamid N Tang HC Yeo KK. Killing two birds with one stone-MitraClip for flail P2 and systolic anterior motion of mitral valve: a case report. Eur Heart J Case Rep. 2018; 2: yty146 PubMed Google Scholar , 5 Montalto C Xaplanteris P. MitraClip implantation in non-obstructive hypertrophic cardiomyopathy: the ever-expanding landscape of transcatheter edge-to-edge repair. Eur Heart J Case Rep. 2022; 6: ytab532 Crossref PubMed Scopus (2) Google Scholar These studies have demonstrated that TMVr is efficacious in improving hemodynamics and reducing symptoms in patients with HC. However, these studies have been limited to case reports or series. To better evaluate this issue, we thus used a large nationwide cohort to determine the outcomes of patients with a history of HC after TMVr with MitraClip.