What does this research mean for the field?

Transcatheter edge-to-edge mitral valve repair significantly reduces mitral regurgitation in both central and noncentral patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The aim is to assess in-hospital outcomes following transcatheter mitral valve repair in patients with severe primary mitral regurgitation.

January 17, 2026Russian Cardiology Bulletin0 citationsOpen Access

Transcatheter edge-to-edge mitral valve repair using G4 clips in the treatment of patients with central and noncentral severe primary mitral regurgitation

MMM.I. MakeevNational Medical Research Center of Cardiology MSM A SaidovaNational Medical Research Center of Cardiology IKI.V. KuchinNational Medical Research Center of Cardiology

Key Result

Transcatheter edge-to-edge mitral valve repair significantly reduced mitral regurgitation in both central (p<0.001) and noncentral patients, with comparable technical success rates.

Key Points

The aim is to assess in-hospital outcomes following transcatheter mitral valve repair in patients with severe primary mitral regurgitation.
Included 62 high-risk patients, categorized into central and noncentral mitral regurgitation groups.
Implanted MitraClip G4 devices and assessed outcomes using echocardiography.
Measured left ventricular volumetric dimensions and ejection fraction pre- and post-intervention.
Significant reduction in mitral regurgitation observed in both groups postoperatively (p<0.001).
Technical success rates were high (95.6% central MR, 82.4% noncentral MR, p=0.12).
Left ventricular end-diastolic volume decreased significantly in central MR patients (p<0.001), showing better hemodynamic improvement.

Structured PICO

Does transcatheter edge-to-edge mitral valve repair using G4 clips effectively reduce mitral regurgitation in high-risk patients with central and noncentral severe primary mitral regurgitation?

Population

62 high-risk patients with severe symptomatic primary mitral regurgitation (PMR), including 45 (72.6%) with central MR and 17 (27.4%) with noncentral MR, mean age 75, 58.1% men.

Intervention

Transcatheter edge-to-edge mitral valve repair (TMVR) using MitraClip G4 devices.

Comparator

Central vs. noncentral MR (observational comparison)

Outcome

In-hospital outcomes including technical success rate, MR reduction, and echocardiographic hemodynamic parameters at 4-5 days post-intervention.surrogate

TMVR using G4 clips is technically feasible and effective in reducing mitral regurgitation and improving early hemodynamics in high-risk patients with both central and noncentral severe primary mitral regurgitation.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Objective. To evaluate in-hospital outcomes in patients with central and noncentral severe primary mitral regurgitation (PMR) after transcatheter edge-to-edge mitral valve repair (TMVR). Material and methods. The study included 62 high risk patients with severe symptomatic PMR: group 1 — 45 (72.6%) patients with central mitral regurgitation (MR), group 2 — 17 (27.4%) patients with noncentral MR. Mean age was 75 68; 83 years, and 58.1% of patients were men. MitraClip G4 devices were implanted. Left ventricular (LV) volumetric dimensions, ejection fraction, and central hemodynamic parameters were assessed using echocardiography at baseline and 4-5 days after intervention. A detailed quantitative analysis of MR was performed, and mean mitral valve pressure gradient was calculated. Results. In early postoperative period, MR significantly reduced in both groups (p<0.001). Technical success rate was comparable in both cohorts (95.6% in central MR and 82.4% in noncentral MR, p=0.12). Hemodynamic efficacy of TMVR was more obvious in the 1st group as evidenced left ventricular end-diastolic volume (LVEDV) and LV central hemodynamic parameters. LVEDV decreased in the first group from 140 103; 161 to 113 87; 140 ml (p<0.001), in the second group — from 118 94; 170 to 110 83; 166 ml (p=0.015). Chordae tendineae rupture did not affect technical success of TMVR, but was associated with implantation of two clips (p=0.03). The number of clips did not differ between patients with central (1.56) and noncentral (1.53) MR (p=0.88). TMVR increased mean mitral valve pressure gradient in both cohorts of patients. However, this parameter was similar in postoperative period in both groups with increased number of clips. Conclusion. Transcatheter edge-to-edge mitral valve repair using G4 clips is an effective correction of central and noncentral severe primary mitral regurgitation.

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