Körber MI, et al. - A single centre analysis was undertaken to investigate bleeding complications after percutaneous edge-to-edge mitral valve repair (PMVR). Data reported a relevant incidence of bleeding post-PMVR and, the majority of bleedings were not access site-related, as seen in contrast to other cardiovascular interventions. Worse outcomes were observed particularly in patients with obscure bleeding, which are not included in the Mitral Valve Academic Research Consortium (MVARC) endpoint definitions and hence, a more intensive work-up was recommended for these subjects.

Methods

• Researchers conducted a single centre analysis including 347 consecutive patients undergoing PMVR.
• Bleeding was defined according to the MVARC endpoint definition.

Results

• Findings demonstrated that the incidence of MVARC bleeding was 21.6% (n=75), major MVARC bleeding (hemoglobin drop ≥3g/dl) occurred in 7.4% (n=26).
• Researchers found that only 33.3% of all bleeding cases were access site-related.
• Multivariate regression analyses revealed that independent predictors of MVARC bleeding were the presence of coronary artery disease (2.809, 95%-CI 1.123-7.022, p=0.027) and intervention duration (1.010, 95%-CI 1.002-1.018, p=0.010).
• Additionally, longer hospital stays were noted in patients suffering from MVARC bleeding (p=0.026), however neither major nor extensive MVARC bleeding was associated with increased 30-day or 1-year mortality.
• Data also reported that a drop in hemoglobin levels ≥3g/dl without clinically visible bleeding sign – not considered in the MVARC bleeding definition – occurred in 9.5% of patients.
• A strong association of a hemoglobin drop of ≥4g/dl with worse survival was observed in these patients with obscure bleeding.