Key result
TEER with MitraClip G4 achieves MR ≤ 2+ in 98% of patients at one year.
Why the study?
For patients with mitral regurgitation unsuitable for surgery, the study sought to evaluate procedural, echocardiographic, functional, and quality of life outcomes with the MitraClip G4 system, and predictors of NYHA class I.
Does transcatheter mitral edge-to-edge repair with the MitraClip G4 system improve MR severity, functional class, and quality of life in patients with severe mitral regurgitation?
Cohort (n=83)
No
Does transcatheter mitral edge-to-edge repair with the MitraClip G4 system improve MR severity, functional class, and quality of life in patients with severe mitral regurgitation?
TEER with the MitraClip G4 system is highly effective at reducing MR severity and improving functional status and quality of life at 1 year in patients with severe mitral regurgitation.
May support MitraClip G4 use in severe MR; leaves open need for randomized confirmation.
Background: Mitral regurgitation (MR) is a common valvular disorder linked to high morbidity and mortality. For patients unsuitable for surgery, transcatheter mitral edge-to-edge repair (TEER) with the MitraClip® G4 system offers an alternative. This study aims to evaluate procedural, echocardiographic, functional, and quality of life (QoL) outcomes in patients who underwent TEER with the MitraClip® G4 system, along with possible predictors of New York Heart Association (NYHA) class I at 30 days and at 1 year. Methods: Patients with moderate-to-severe (3+) or severe (4+) degenerative MR (DMR) or functional MR (FMR), classified as NYHA class III or IV, and who underwent TEER with the MitraClip® G4 system at our center between January 2021 and December 2023 were included. Results: A total of 83 patients [71% FMR, 66% male, median (IQR) age 70 (11) years] underwent TEER, with 100% procedural success. MR ≤ 2+ was achieved in 100% and 98% of patients at 30 days and 1 year, respectively. NYHA class I or II was achieved in 100% and 96.8% of patients at 30 days and 1 year, respectively. The Kansas City Cardiomyopathy Questionnaire (KCCQ) score improved from 51 ± 20 at baseline to 69 ± 15 at 30 days (p < 0.001) and 70.5 ± 15 at 1 year (p < 0.001). Lower baseline N-terminal pro-brain natriuretic peptide (NT-proBNP) predicted achieving NYHA class I at 30 days (HR: 0.63, 95% CI: 0.41–0.95, p = 0.030), while lower European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and NT-proBNP predicted it at 1 year [(HR: 0.50, 95% CI: 0.28–0.89, p = 0.019), (HR: 0.67, 95% CI: 0.44–0.99, p = 0.049), respectively]. Conclusions: The MitraClip® G4 system provides significant improvements in MR severity, functional class, and QoL. Lower NT-proBNP and EuroSCORE II were strong predictors of achieving optimal functional status (NYHA class I).
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Papadopoulos et al. (2024) conducted a cohort in Mitral regurgitation (n=83). Transcatheter mitral edge-to-edge repair (TEER) with the MitraClip G4 system was evaluated on MR ≤ 2+ at 1 year. TEER with the MitraClip G4 system achieved 100% procedural success and resulted in MR ≤ 2+ in 98% of patients at 1 year, with significant improvements in functional class and quality of life.
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