Edge-to-Edge Mitral Valve Repair With Extended Clip Arms: Early Experience From a Multicenter Observational Study.

Praz, Fabien; Braun, Daniel; Unterhuber, Matthias; Spirito, Alessandro; Orban, Mathias; Brugger, Nicolas; Brinkmann, Isabel; Spring, Karin; Moschovitis, Aris; Nabauer, Michael; Blazek, Stephan; Pilgrim, Thomas; Thiele, Holger; Lurz, Philipp; Hausleiter, Jörg; Windecker, Stephan (2019). Edge-to-Edge Mitral Valve Repair With Extended Clip Arms: Early Experience From a Multicenter Observational Study. JACC. Cardiovascular Interventions, 12(14), pp. 1356-1365. Elsevier 10.1016/j.jcin.2019.03.023

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Praz, Fabien; Pilgrim, Thomas and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1876-7605

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

11 Feb 2020 08:35

Last Modified:

11 Feb 2020 08:35

Publisher DOI:

10.1016/j.jcin.2019.03.023

PubMed ID:

31129091

Uncontrolled Keywords:

MitraClip mitral regurgitation mitral valve transcatheter mitral valve repair

BORIS DOI:

10.7892/boris.139139

URI:

https://boris.unibe.ch/id/eprint/139139

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