Transcatheter Edge-to-Edge Mitral Valve Repair With the MitraClip G4 System

被引：90

作者：

Chakravarty, Tarun ^{[1
]}

Makar, Moody ^{[1
]}

Patel, Dhairya ^{[1
]}

Oakley, Luke ^{[1
]}

Yoon, Sung Han ^{[1
]}

Stegic, Jasminka ^{[1
]}

Singh, Siddharth ^{[1
]}

Skaf, Sabah ^{[1
]}

Nakamura, Mamoo ^{[1
]}

Makkar, Raj R. ^{[1
]}

机构：

[1] Cedars Sinai Med Ctr, Smidt Heart Inst, 8700 Beverly Blvd, Los Angeles, CA 90048 USA

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2020年 / 13卷 / 20期

关键词：

MitraClip G4; mitral regurgitation; TRIAL DESIGN PRINCIPLES; END-POINT DEFINITIONS; PERCUTANEOUS REPAIR; CONSENSUS DOCUMENT; EXPERIENCE;

D O I：

10.1016/j.jcin.2020.06.053

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVES The primary objective of this study was to evaluate the effectiveness of the MitraClip G4 in the reduction of mitral regurgitation (MR). BACKGROUND The next-generation MitraClip G4 system was recently introduced for the treatment of MR in the United States. METHODS The study included consecutive patients undergoing transcatheter mitral edge-to-edge repair for MR with the MitraClip G4. The key outcome was the proportion of patients with MR reduction to <= 2+ at 30 days. RESULTS Fifty-nine patients (median age 77 years, 62.7% men) were treated with the MitraClip G4. Reduction of MR to <= 2+ was achieved in 57 patients (96.6%) during the procedure, 58 patients (98.3%) at discharge, and 57 patients (96.6%) by 30 days. The median number of MitraClips used per patient was 2 (interquartile range: 1 to 3). Wide clips (NTW/XTW) were used in 82.7% of patients. The XTW clip was used most frequently as the first clip in patients with degenerative MR (65.4%) and the NTW clip in those with secondary MR (72.7%). The independent grasping mechanism was used in 49.2% of patients. CONCLUSIONS Use of the MitraClip G4 system was associated with excellent reduction in MR to <= 2+ in 96.6% of patients at 30 days. The availability of multiple MitraClip G4 sizes, especially the wide clips, and the ability to independently grasp leaflets are the likely contributors to MR reduction. (C) 2020 by the American College of Cardiology Foundation.

引用

页码：2402 / 2414

页数：13

共 12 条

[1] Institutional Experience With Transcatheter Mitral Valve Repair and Clinical Outcomes Insights From the TVT Registry [J].

Chhatriwalla, Adnan K. ;

Vemulapalli, Sreekanth ;

Holmes, David R., Jr. ;

Dai, Dadi ;

Li, Zhuokai ;

Ailawadi, Gorav ;

Glower, Donald ;

Kar, Saibal ;

Mack, Michael J. ;

Rymer, Jennifer ;

Kosinski, Andrzej S. ;

Sorajja, Paul .

JACC-CARDIOVASCULAR INTERVENTIONS, 2019, 12 (14) :1342-1352

[2] 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

[3] Continuous Direct Left Atrial Pressure Intraprocedural Measurement Predicts Clinical Response Following MitraClip Therapy [J].

Kuwata, Shingo ;

Taramasso, Maurizio ;

Czopak, Albert ;

Luciani, Marco ;

Pozzoli, Alberto ;

Ho, Edwin ;

Guadagnoli, Adolfo Ferrero ;

Saccocci, Matteo ;

Gaemperli, Oliver ;

Nietlispach, Fabian ;

Zuber, Michel ;

Feldman, Ted ;

Maisano, Francesco .

JACC-CARDIOVASCULAR INTERVENTIONS, 2019, 12 (02) :127-136

[4]

Nishimura RA., 2017, J AM COLL CARDIOL, V70, P252, DOI DOI 10.1016/J.JACC.2017.03.011

[5] Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation [J].

Obadia, J. -F. ;

Messika-Zeitoun, D. ;

Leurent, G. ;

Iung, B. ;

Bonnet, G. ;

Piriou, N. ;

Lefevre, T. ;

Piot, C. ;

Rouleau, F. ;

Carrie, D. ;

Nejjari, M. ;

Ohlmann, P. ;

Leclercq, F. ;

Saint Etienne, C. ;

Teiger, E. ;

Leroux, L. ;

Karam, N. ;

Michel, N. ;

Gilard, M. ;

Donal, E. ;

Trochu, J. -N. ;

Cormier, B. ;

Armoiry, X. ;

Boutitie, F. ;

Maucort-Boulch, D. ;

Barnel, C. ;

Samson, G. ;

Guerin, P. ;

Vahanian, A. ;

Mewton, N. .

NEW ENGLAND JOURNAL OF MEDICINE, 2018, 379 (24) :2297-2306

[6] Edge-to-Edge Mitral Valve Repair With Extended Clip Arms Early Experience From a Multicenter Observational Study [J].

Praz, Fabien ;

Braun, Daniel ;

Unterhuber, Matthias ;

Spirito, Alessandro ;

Orban, Mathias ;

Brugger, Nicolas ;

Brinkmann, Isabel ;

Spring, Karin ;

Moschovitis, Aris ;

Nabauer, Michael ;

Blazek, Stephan ;

Pilgrim, Thomas ;

Thiele, Holger ;

Lurz, Philipp ;

Hausleiter, Joerg ;

Windecker, Stephan .

JACC-CARDIOVASCULAR INTERVENTIONS, 2019, 12 (14) :1356-1365

[7] Initial Experience With Commercial Transcatheter Mitral Valve Repair in the United States [J].

Sorajja, Paul ;

Mack, Michael ;

Vemulapalli, Sreekanth ;

Holmes, David R. ;

Stebbins, Amanda ;

Kar, Saibal ;

Lim, Scott ;

Thourani, Vinod ;

McCarthy, Patrick ;

Kapadia, Samir ;

Grayburn, Paul ;

Pedersen, Wesley A. ;

Ailawadi, Gorav .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2016, 67 (10) :1129-1140

[8] Transcatheter Mitral-Valve Repair in Patients with Heart Failure [J].

Stone, G. W. ;

Lindenfeld, J. A. ;

Abraham, W. T. ;

Kar, S. ;

Lim, D. S. ;

Mishell, J. M. ;

Whisenant, B. ;

Grayburn, P. A. ;

Rinaldi, M. ;

Kapadia, S. R. ;

Rajagopal, V. ;

Sarembock, I. J. ;

Brieke, A. ;

Marx, S. O. ;

Cohen, D. J. ;

Weissman, N. J. ;

Mack, M. J. .

NEW ENGLAND JOURNAL OF MEDICINE, 2018, 379 (24) :2307-2318

[9] Clinical Trial Design Principles and Endpoint Definitions for Transcatheter Mitral Valve Repair and Replacement: Part 1: Clinical Trial Design Principles A Consensus Document From the Mitral Valve Academic Research Consortium [J].

Stone, Gregg W. ;

Vahanian, Alec S. ;

Adams, David H. ;

Abraham, William T. ;

Borer, Jeffrey S. ;

Bax, Jeroen J. ;

Schofer, Joachim ;

Cutlip, Donald E. ;

Krucoff, Mitchell W. ;

Blackstone, Eugene H. ;

Genereux, Philippe ;

Mack, Michael J. ;

Siegel, Robert J. ;

Grayburn, Paul A. ;

Enriquez-Sarano, Maurice ;

Lancellotti, Patrizio ;

Filippatos, Gerasimos ;

Kappetein, Arie Pieter .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2015, 66 (03) :278-307

[10] Clinical Trial Design Principles and Endpoint Definitions for Transcatheter Mitral Valve Repair and Replacement: Part 2: Endpoint Definitions A Consensus Document From the Mitral Valve Academic Research Consortium [J].

Stone, Gregg W. ;

Adams, David H. ;

Abraham, William T. ;

Kappetein, Arie Pieter ;

Genereux, Philippe ;

Vranckx, Pascal ;

Mehran, Roxana ;

Kuck, Karl-Heinz ;

Leon, Martin B. ;

Piazza, Nicolo ;

Head, Stuart J. ;

Filippatos, Gerasimos ;

Vahanian, Alec S. .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2015, 66 (03) :308-321

← 1 2 →