Journal article
Edge-to-Edge Mitral Valve Repair With Extended Clip Arms: Early Experience From a Multicenter Observational Study.
- Praz F Department of Cardiology, University Hospital, University of Bern, Bern, Switzerland.
- Braun D Medizinische Klinik und Poliklinik I, Ludwig Maximilians Universität München, München, Germany.
- Unterhuber M Department of Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany.
- Spirito A Department of Cardiology, University Hospital, University of Bern, Bern, Switzerland.
- Orban M Medizinische Klinik und Poliklinik I, Ludwig Maximilians Universität München, München, Germany.
- Brugger N Department of Cardiology, University Hospital, University of Bern, Bern, Switzerland.
- Brinkmann I Medizinische Klinik und Poliklinik I, Ludwig Maximilians Universität München, München, Germany.
- Spring K Department of Cardiology, University Hospital, University of Bern, Bern, Switzerland.
- Moschovitis A Department of Cardiology, University Hospital, University of Bern, Bern, Switzerland.
- Nabauer M Medizinische Klinik und Poliklinik I, Ludwig Maximilians Universität München, München, Germany.
- Blazek S Department of Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany.
- Pilgrim T Department of Cardiology, University Hospital, University of Bern, Bern, Switzerland.
- Thiele H Department of Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany.
- Lurz P Department of Cardiology, Heart Center Leipzig-University Hospital, Leipzig, Germany.
- Hausleiter J Medizinische Klinik und Poliklinik I, Ludwig Maximilians Universität München, München, Germany. Electronic address: joerg.hausleiter@med.uni-muenchen.de.
- Windecker S Department of Cardiology, University Hospital, University of Bern, Bern, Switzerland.
- 2019-05-27
Published in:
- JACC. Cardiovascular interventions. - 2019
MitraClip
mitral regurgitation
mitral valve
transcatheter mitral valve repair
Aged
Aged, 80 and over
Cardiac Catheterization
Female
Germany
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Hemodynamics
Humans
Male
Mitral Valve
Mitral Valve Insufficiency
Prosthesis Design
Recovery of Function
Risk Factors
Switzerland
Time Factors
Treatment Outcome
English
OBJECTIVES
The aim of this study was to investigate the technical success and efficacy of mitral valve edge-to-edge repair using extended clip arms.
BACKGROUND
A new iteration of the MitraClip system, the MitraClip XTR, was introduced in 2018 with the aim of addressing technical limitations observed with previous versions.
METHODS
Patients having received at least 1 new implant for the treatment of symptomatic mitral regurgitation (MR) were eligible for this study.
RESULTS
Among the 107 patients (mean age 76 ± 9 years, 69% men) included in this study, the etiology of MR was balanced, with one-half (n = 53 [50%]) classified as secondary and the remaining 54 patients having either primary (n = 40 [37%]) or mixed (n = 14 [13%]) disease. The mean number of devices implanted was 1.5 ± 0.6. Multiple device implantation was required in 46 patients (43%). Single-leaflet device attachment occurred in 4 patients and leaflet injury in 2 additional patients, requiring surgical conversion in 4 patients. Among the 102 patients discharged alive without mitral valve surgery, 95 (93%) had MR ≤2+ and 79 (77%) had MR ≤1+. The mean transmitral gradient increased from 1.9 ± 1.0 mm Hg at baseline to 3.5 ± 1.8 mm Hg at discharge (p < 0.001).
CONCLUSIONS
Technical success with the new mitral valve repair system with extended clip arm was achieved in 93% of the patients. MR ≤2+ was obtained in 95 patients (93%) and MR ≤1+ in 79 (77%). The main reasons for procedural failure were acute single-leaflet device attachment associated with leaflet damage or isolated leaflet injury and often required surgical correction.
The aim of this study was to investigate the technical success and efficacy of mitral valve edge-to-edge repair using extended clip arms.
BACKGROUND
A new iteration of the MitraClip system, the MitraClip XTR, was introduced in 2018 with the aim of addressing technical limitations observed with previous versions.
METHODS
Patients having received at least 1 new implant for the treatment of symptomatic mitral regurgitation (MR) were eligible for this study.
RESULTS
Among the 107 patients (mean age 76 ± 9 years, 69% men) included in this study, the etiology of MR was balanced, with one-half (n = 53 [50%]) classified as secondary and the remaining 54 patients having either primary (n = 40 [37%]) or mixed (n = 14 [13%]) disease. The mean number of devices implanted was 1.5 ± 0.6. Multiple device implantation was required in 46 patients (43%). Single-leaflet device attachment occurred in 4 patients and leaflet injury in 2 additional patients, requiring surgical conversion in 4 patients. Among the 102 patients discharged alive without mitral valve surgery, 95 (93%) had MR ≤2+ and 79 (77%) had MR ≤1+. The mean transmitral gradient increased from 1.9 ± 1.0 mm Hg at baseline to 3.5 ± 1.8 mm Hg at discharge (p < 0.001).
CONCLUSIONS
Technical success with the new mitral valve repair system with extended clip arm was achieved in 93% of the patients. MR ≤2+ was obtained in 95 patients (93%) and MR ≤1+ in 79 (77%). The main reasons for procedural failure were acute single-leaflet device attachment associated with leaflet damage or isolated leaflet injury and often required surgical correction.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.jcin.2019.03.023
- PMID 31129091
- Persistent URL
- https://sonar.ch/global/documents/141017
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