Percutaneous Mitral Repair With the MitraClip System
Why the study?
Does percutaneous mitral repair with the MitraClip system improve freedom from death, mitral valve surgery, or MR >2+ in patients with 3 to 4+ mitral regurgitation?
Population
107 patients with 3 to 4+ mitral regurgitation selected in accordance with AHA/ACC guidelines for intervention
Design
Cohort
Follow-up
12 months (primary endpoint), up to 3.2 years
Key result
Percutaneous mitral repair with the MitraClip system achieved acute procedural success in 74% of patients, with 66% of successfully treated patients free from death, surgery, or MR >2+ at 12 months.
Authors
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Captured external expert commentary on this paper, strongest first. Original sources linked on every quote.
“Current procedures target leaflet modification; various percutaneous annuloplasty approaches are under investigation, but most are in early stages of development. Treatment of MR with percutaneous coronary sinus annuloplasty is intuitively attractive, but there are technical limitations.”
“Successful clip placement occurred in 90% of patients; two clips were required in 32%. All echocardiograms were evaluated by a core laboratory before patient enrollment. This was the first trial of an MR device therapy to utilize both an echo core lab and also prospective qualification of patients.”
“The Achilles heel of MitraClip is that it cannot completely eliminate the regurgitation. In another words, some leakage is likely to continue even after the clip is placed. For those with severe MR who can withstand surgery, surgical repair or replacement is still the preferred treatment.”
May support percutaneous edge-to-edge repair in selected MR patients; leaves open durability and efficacy versus surgery in randomized trials.
Does percutaneous mitral repair with the MitraClip system improve freedom from death, mitral valve surgery, or MR >2+ in patients with 3 to 4+ mitral regurgitation?
Percutaneous mitral repair with the MitraClip system is feasible and safe, achieving acute MR reduction and sustained freedom from death, surgery, or recurrent MR in a substantial proportion of patients.
Feldman et al. (2009) studied Mitral regurgitation (n=107). MitraClip system was evaluated on Freedom from death, mitral valve surgery, or MR >2+ at 12 months. Percutaneous mitral repair with the MitraClip system achieved acute procedural success in 74% of patients, with 66% of successfully treated patients free from death, surgery, or MR >2+ at 12 months.