Effect of percutaneous mitral repair with the MitraClip® device on mitral valve area and gradient

Howard C. Herrmann, Saibal Kar, Robert Siegel, Peter Fail, Catalin Loghin, Scott Lim, Rebecca Hahn, Jason H Rogers, William J Bommer, Andrew Wang, Andrew Berke, Stamatios Lerakis, Paul Kramer, S. Chiu Wong, Elyse Foster, Don Glower, Ted Feldman

Research output: Contribution to journalArticle

85 Scopus citations

Abstract

Aims: Percutaneous repair of mitral regurgitation (MR) by leaflet apposition using a clip deployed via transseptal catheterisation is undergoing evaluation. Methods and results: In order to detect the potential for clinically significant left ventricular inflow obstruction after percutaneous repair, we measured mitral valve area (MVA) and mean transmitral gradient (MVG) echocardiographically in 96 patients implanted with a clip followed for up to 24 months. By planimetry, the mean MVA decreased from 6.0±1.3 cm 2 to 3.6±1.2 cm2 (p<0.05) (range 1.9 to 7.6 cm2) after clip placement, and remained unchanged after 24 months of follow-up (3.5±0.8 cm2). The mean MVG increased after clip placement from 1.7±0.9 mmHg to 4.1±2.2 mmHg (p<0.05), and did not increase further to 24 months (3.8±1.9 mmHg). There were no differences in MVA or MVG between patients who received 1-clip (69%) and those receiving 2-clips (31%). Patients with functional MR (23%) had a slightly smaller MVA, both at baseline and after clip placement, but did not differ from degenerative MR patients at later follow-up. After 2 years of follow-up, no patient required surgery for LV inflow obstruction. Conclusions: Mitral repair with the MitraClip® device for MR decreases MVA without significant mitral obstruction. After 2 years of follow-up, no patient required surgery for LV inflow obstruction, and these results were not influenced by the use of more than 1 clip or the aetiology of MR.

Original languageEnglish (US)
Pages (from-to)437-442
Number of pages6
JournalEuroIntervention
Volume4
Issue number4
DOIs
StatePublished - Jan 2009
Externally publishedYes

Keywords

  • Mitral repair
  • Mitral stenosis
  • Mitral valve regurgitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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