What is the clinical evidence from this study?

Study design: Observational. Population: Functional and degenerative mitral regurgitation (n=60). Intervention: MitraClip. Primary outcome: Acute changes in mitral annular shape and dimensions, and their effect on MR severity.

What question did this study set out to answer?

This research aims to evaluate the acute changes in the shape and size of the mitral annulus after edge-to-edge percutaneous mitral valve repair, and their relationship with mitral regurgitation severity.

February 22, 2019Echocardiography

The acute effects of edge‐to‐edge percutaneous mitral valve repair on the shape and size of the mitral annulus and its relation to mitral regurgitation

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Key result

MitraClip significantly reduced mitral annular dimensions in patients with functional or degenerative mitral regurgitation, but these changes did not correlate with immediate MR reduction.

Why the study?

The effects of edge-to-edge percutaneous mitral valve repair on mitral annular shape and size and their relation to MR have not been well characterized.

Does edge-to-edge percutaneous mitral valve repair affect mitral annular dimensions and correlate with acute mitral regurgitation reduction in patients with functional or degenerative mitral regurgitation?

Key Points

This research aims to evaluate the acute changes in the shape and size of the mitral annulus after edge-to-edge percutaneous mitral valve repair, and their relationship with mitral regurgitation severity.
Retrospective review of patients who underwent MitraClip from January 2013 to May 2016.
patients with inadequate images, prior repairs, and rapid atrial fibrillation were excluded.
Intra-procedure 3D transesophageal echocardiography (TEE) was used to analyze mitral annular dimensions before and after MitraClip implantation.
Of 78 patients, 60 met eligibility criteria; 37 had severe mitral regurgitation (4+) and 23 moderately/severe (3+).
All patients achieved a reduction in MR severity to ≤2.
Significant reductions in 3D annular circumference, bicommissural diameter, and anteroposterior diameter were observed, but no significant differences were noted between large and small MR change groups.

Study Design

Type

Observational (n=60)

Multicenter

Structured PICO

Population

60 patients (mean age 78.3 years) with functional or degenerative mitral regurgitation who underwent MitraClip repair, evaluated for acute changes in mitral annular dimensions.

Exposure

Edge-to-edge percutaneous mitral valve repair (MitraClip)

Outcome

Acute changes in mitral annular shape and dimensions (3D annular circumference, bicommissural diameter, and anteroposterior diameter) and their effect on MR severity, measured via intra-procedure TEE 3D images prior to and after implantationsurrogate

Edge-to-edge percutaneous mitral valve repair significantly reduces mitral annular dimensions acutely, but these structural changes do not correlate with the immediate reduction in mitral regurgitation severity.

Discussion

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Implication

Acute annular reduction after MitraClip does not predict immediate MR improvement; leaves open mechanisms beyond edge-to-edge coaptation.

Cite This Study

Dönmez et al. (2019) conducted an observational in Functional and degenerative mitral regurgitation (n=60). MitraClip was evaluated on Acute changes in mitral annular shape and dimensions, and their effect on MR severity. MitraClip significantly reduced mitral annular dimensions in patients with functional or degenerative mitral regurgitation, but these changes did not correlate with immediate MR reduction.

synapsesocial.com/papers/6a20970f2ad198cbe7f36614 https://doi.org/10.1111/echo.14284

Topics

Mitral valve intervention

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