Abstract
Background and aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system. Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017. The cohort was divided into three groups according to the use of the first-generation Mitraclip during the first (control-1) or second half (control-2) or the Mitraclip NT system. Results: A total of 545 consecutive patients were included in the study. Among all, 182 (33.3%), 183 (33.3%), and 180 (33.3%) patients underwent mitral repair in the control-1, control-2, and NT cohorts, respectively. Procedural success was achieved in 93.3% of patients without differences between groups. Major adverse events did not statistically differ among groups, but there was a higher rate of pericardial effusion in the control-1 group (4.3%, 0.6%, and 2.6%, respectively; p = 0.025). The composite endpoint of death, surgery, and admission for congestive heart failure (CHF) at 12 months was lower in the NT group (23.5% in control-1, 22.5% in control-2, and 8.3% in the NT group; p = 0.032). Conclusions: The present paper shows that contemporary clinical outcomes of patients undergoing PMVR with the Mitraclip system have improved over time.
Highlights
Percutaneous mitral valve repair (PMVR) with the Mitraclip system has been growing over the last years
A total of 545 consecutive patients with mitral regurgitation (MR) who underwent percutaneous mitral valve repair (PMVR) with Mitraclip were included in the study
No significant baseline clinical and echocardiographic differences were observed between both groups, but a higher proportion of females, older patients, atrial fibrillation, degenerative MR (DMR), and higher Society of Thoracic Surgeons. (STS) score was identified in the NT group (Table 1)
Summary
Percutaneous mitral valve repair (PMVR) with the Mitraclip system has been growing over the last years. Clinical improvement after PMVR is related to several factors such as the clinical status of the patient before the intervention, the presence of comorbidities, or the MR degree before and after the procedure [10,11] All these factors, somehow linked to the overall learning curve of the procedure, seemed to differ between these two randomized trials and might explain the differences in clinical outcomes. Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve for procedural outcomes and for patient selection.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
