One- and Twelve-Month Safety and Efficacy Outcomes of Patients Undergoing Edge-to-Edge Percutaneous Mitral Valve Repair (from the GRASP Registry)

被引:116
作者
Grasso, Carmelo [1 ]
Capodanno, Davide [1 ,2 ]
Scandura, Salvatore [1 ]
Cannata, Stefano [1 ]
Imme, Sebastiano [1 ]
Mangiafico, Sarah [1 ]
Pistritto, Anna [1 ]
Ministeri, Margherita [1 ]
Barbanti, Marco [1 ]
Caggegi, Anna [1 ]
Chiaranda, Marta [1 ]
Dipasqua, Fabio [1 ]
Giaquinta, Sandra [1 ]
Occhipinti, Michele [1 ]
Ussia, Gianpaolo [1 ]
Tamburino, Corrado [1 ,2 ]
机构
[1] Univ Catania, Cardiovasc Dept, Ferrarotto Hosp, Catania, Italy
[2] Excellence Newest Adv Fdn, Catania, Italy
关键词
REGURGITATION; SURGERY; THERAPY; INTERVENTIONS; SEVERITY;
D O I
10.1016/j.amjcard.2013.01.300
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The aim of this study was to report on the 30-day and 1-year outcomes of percutaneous mitral valve repair with the MitraClip technique in patients with grade >= 3 + mitral regurgitation (MR) at high risk for conventional surgical therapy enrolled in the prospective Getting Reduction of Mitral Insufficiency by Percutaneous Clip Implantation (GRASP) registry. Acute device success was defined as residual MR <= 2 + after clip implantation. The primary safety end point was the rate of major adverse events at 30 days. The Primary efficacy end point was freedom from death, surgery for mitral valve dysfunction, or grade >= 3 + MR at 30 days and 1 year. A total of 117 patients were treated. Eighty-nine patients (76%) presented with functional MR and 28 patients (24%) with organic MR. Acute device success was observed in all patients. Device implantation time significantly diminished with experience and varied significantly between cases with 1 versus >= 2 clips. No procedural mortality, was recorded. Major adverse events occurred in 4 patients at 30 days (4.3%). Deterioration to MR >= 3 + was recorded in 25% of patients with degenerative MR and 7% of those with functional MR at 1 year. No surgery for mitral valve dysfunction occurred within 1 year. Freedom from death, surgery for mitral valve dysfunction, or grade >= 3 + MR was 96.4% and 75.8% at 30 days and 1 year, respectively. No significant differences were noted in the primary efficacy end point between patients with degenerative MR and those with functional MR. In conclusion, percutaneous mitral valve repair with the MitraClip technique was shown to be safe and reasonably effective in 117 patients from a real-world setting. (c) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:1482 / 1487
页数:6
相关论文
共 18 条
[1]   The double-orifice technique in mitral valve repair: A simple solution for complex problems [J].
Alfieri, O ;
Maisano, F ;
De Bonis, M ;
Stefano, PL ;
Torracca, L ;
Oppizzi, M ;
La Canna, G .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2001, 122 (04) :674-681
[2]   MitraClip therapy in daily clinical practice: initial results from the German transcatheter mitral valve interventions (TRAMI) registry [J].
Baldus, Stephan ;
Schillinger, Wolfgang ;
Franzen, Olaf ;
Bekeredjian, Raffi ;
Sievert, Horst ;
Schofer, Joachim ;
Kuck, Karl-Heinz ;
Konorza, Thomas ;
Moellmann, Helge ;
Hehrlein, Christoph ;
Ouarrak, Taoufik ;
Senges, Jochen ;
Meinertz, Thomas .
EUROPEAN JOURNAL OF HEART FAILURE, 2012, 14 (09) :1050-1055
[3]   In-Hospital Outcome of Patients with Severe Mitral Valve Regurgitation Classified as Inoperable and Treated with the MitraClip® Device [J].
Divchev, Dimitar ;
Kische, Stephan ;
Paranskaya, Liliya ;
Schneider, Henrik ;
Rehders, Tim ;
Ortak, Jasmin ;
Akin, Ibrahim ;
Turan, Goekmen ;
Turan, Cem Hakan ;
Steinhoff, Gustav ;
Noeldge-Schomburg, Gabriele ;
Nienaber, Christoph A. ;
Ince, Hueseyin .
JOURNAL OF INTERVENTIONAL CARDIOLOGY, 2012, 25 (02) :180-189
[4]   Percutaneous Repair or Surgery for Mitral Regurgitation [J].
Feldman, Ted ;
Foster, Elyse ;
Glower, Donald G. ;
Kar, Saibal ;
Rinaldi, Michael J. ;
Fail, Peter S. ;
Smalling, Richard W. ;
Siegel, Robert ;
Rose, Geoffrey A. ;
Engeron, Eric ;
Loghin, Catalin ;
Trento, Alfredo ;
Skipper, Eric R. ;
Fudge, Tommy ;
Letsou, George V. ;
Massaro, Joseph M. ;
Mauri, Laura .
NEW ENGLAND JOURNAL OF MEDICINE, 2011, 364 (15) :1395-1406
[5]   Percutaneous Leaflet Repair and Annuloplasty for Mitral Regurgitation [J].
Feldman, Ted ;
Cilingiroglu, Mehmet .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 57 (05) :529-537
[6]   Percutaneous Mitral Repair With the MitraClip System Safety and Midterm Durability in the Initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) Cohort [J].
Feldman, Ted ;
Kar, Saibal ;
Rinaldi, Michael ;
Fail, Peter ;
Hermiller, James ;
Smalling, Richard ;
Whitlow, Patrick L. ;
Gray, William ;
Low, Reginald ;
Herrmann, Howard C. ;
Lim, Scott ;
Foster, Elyse ;
Glower, Donald .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2009, 54 (08) :686-694
[7]   Quantitative assessment of severity of mitral regurgitation by serial echocardiography in a multicenter clinical trial of percutaneous mitral valve repair [J].
Foster, Elyse ;
Wasserman, Hal S. ;
Gray, William ;
Homma, Shunichi ;
Di Tullio, Marco R. ;
Rodriguez, Leonardo ;
Stewart, William J. ;
Whitlow, Patrick ;
Block, Peter ;
Martin, Randy ;
Merlino, John ;
Herrmann, Howard C. ;
Wiegers, Susan E. ;
Silvestry, Frank E. ;
Hamilton, Andrew ;
Zunamon, Alan ;
Kraybill, Kimberly ;
Gerber, Ivor L. ;
Weeks, Sarah G. ;
Zhang, Yan ;
Feldman, Ted .
AMERICAN JOURNAL OF CARDIOLOGY, 2007, 100 (10) :1577-1583
[8]   MitraClip® therapy in patients with end-stage systolic heart failure [J].
Franzen, Olaf ;
van der Heyden, Jan ;
Baldus, Stephan ;
Schlueter, Michael ;
Schillinger, Wolfgang ;
Butter, Christian ;
Hoffmann, Rainer ;
Corti, Roberto ;
Pedrazzini, Giovanni ;
Swaans, Martin J. ;
Neuss, Michael ;
Rudolph, Volker ;
Suerder, Daniel ;
Gruenenfelder, Juerg ;
Eulenburg, Christine ;
Reichenspurner, Hermann ;
Meinertz, Thomas ;
Auricchio, Angelo .
EUROPEAN JOURNAL OF HEART FAILURE, 2011, 13 (05) :569-576
[9]   The Evolution From Surgery to Percutaneous Mitral Valve Interventions The Role of the Edge-to-Edge Technique [J].
Maisano, Francesco ;
La Canna, Giovanni ;
Colombo, Antonio ;
Alfieri, Ottavio .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 58 (21) :2174-2182
[10]   Multivariable prediction of in-hospital mortality associated with aortic and mitral valve surgery in northern New England [J].
Nowicki, ER ;
Birkmeyer, NJO ;
Weintraub, RW ;
Leavitt, BJ ;
Sanders, JH ;
Dacey, LJ ;
Clough, RA ;
Quinn, RD ;
Charlesworth, DC ;
Sisto, DA ;
Uhlig, PN ;
Olmstead, EM ;
O'Connor, GT .
ANNALS OF THORACIC SURGERY, 2004, 77 (06) :1966-1977