Percutaneous treatment of mitral valve regurgitation: Initial experience with the MitraClip device

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• 作者：Duarte Cacela ; ^{dcacela@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Antó ; nio Fiarresga ; Luí ; sa Branco ; Ana Galrinho ; Pedro Rio ; Mafalda Selas ; Rui Ferreira
• 关键词：MitraClip ; Mitral regurgitation ; Percutaneous mitral valve repair ; Functional mitral regurgitation ; Transcatheter mitral repair
• 刊名：Revista Portuguesa de Cardiologia (English Edition)
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：34
• 期：9
• 页码：515-524
• 全文大小：1996 K

文摘

Mitral regurgitation (MR) is the most common valvular disease and has recently been the target of a number of percutaneous approaches. The MitraClip is virtually the only device for which there is considerable experience, with more than 20 000 procedures performed worldwide.

Objective

To describe our initial experience of the percutaneous treatment of MR with the MitraClip device.

Methods

We describe the first six MitraClip cases performed in this institution (mean age 58.5±13.1 years), with functional MR grade 4+ and New York Heart Association (NYHA) heart failure class III or IV (n=3), with a mean follow-up of 290±145 days.

Results

Procedural success (MR ≤2+) was 100%. Total procedure time was 115.8±23.7 min, with no in-hospital adverse events and discharge between the fourth and eighth day, and consistent improvement in the six-minute walk test (329.8±98.42 vs. 385.33±106.95 m) and in NYHA class (three patients improved by two NYHA classes). During follow-up there were two deaths, in two of the four patients who had been initially considered for heart transplantation.

Conclusion

In patients with functional MR the MitraClip procedure is safe, with both a high implantation and immediate in-hospital success rate. A longer follow-up suggests that the clinical benefit decreases or disappears completely in patients with more advanced heart disease, namely those denied transplantation or on the heart transplant waiting list.