Italian Society of Interventional Cardiology ( <scp>GIse</scp> ) registry Of Transcatheter treatment of mitral valve r <scp>egurgitaTiOn</scp> ( <scp>GIOTTO</scp> ): impact of valve disease aetiology and residual mitral regurgitation after <scp>MitraClip</scp> implantation

Aims The Italian Society of Interventional Cardiology (GIse) registry Of Transcatheter treatment mitral valve regurgitaTiOn (GIOTTO) was conceived in order to assess the safety and efficacy MitraClip therapy Italy. aim this study procedural mid-term outcomes, clinical echocardiographic predictors mortality after therapy, stratifying results according diagnosis functional degenerative regurgitation (FMR vs. DMR). Methods Between January 2016 March 2020, 1659 patients were prospectively included GIOTTO 59.4% DMR 40.6%). Acute Mitral Valve Academic Research Consortium (MVARC) technical success achieved 97.2% patients, without differences between FMR with sustained at 30 days. In population, all-cause 4.0%, 17.5% 34.6% days, 1 year 2 years, respectively. Cardiovascular death most frequent cause mortality. Overall hospitalization rates 6.3%, 23.4% 31.7% heart failure, particularly first MVARC structural failure strongly associated 1-year Residual 1+ (rMR) independently related a reduced risk (hazard ratio 0.62; P = 0.005). Coherently, 2-year follow up, worse outcomes than DMR, Kaplan–Meier rMR. Conclusions Functional aetiology affects implantation, can be observed within years. Optimal rMR correlated more favourable outcome, FMR.