Anatomical Changes after Transcatheter Edge-to-Edge Repair in Functional MR According to MitraClip Generation.

mitral regurgitation mitral valve transcatheter mitral edge-to-edge repair

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
13 Feb 2023
Historique:
received: 28 12 2022
revised: 01 02 2023
accepted: 10 02 2023
entrez: 25 2 2023
pubmed: 26 2 2023
medline: 26 2 2023
Statut: epublish

Résumé

The use of mitral transcatheter edge-to-edge repair (TEER) is rapidly increasing. Anatomical changes have been described after TEER with the MitraClip system in patients with functional mitral regurgitation (MR), although no study has yet evaluated such anatomical impacts in patients treated with the G4 MitraClip generation. This research constituted a prospective, single-center, observational study including consecutive patients with functional MR. Mitral three-dimensional images were obtained transesophageally with echocardiography before and immediately after TEER. Patients receiving the late-generation (G4) system were compared to those receiving early-generation systems. A total of 116 functional MR patients were evaluated, and 40 (34.5%) and 76 (65.5%) received a late-generation (G4) or early-generation device system, respectively. The baseline clinical and echocardiographic features were well-balanced between the groups. Overall, there was a significant reduction in mitral annular size after the intervention, and greater reductions in the anteroposterior diameter (4 mm vs. 3.54 mm, In patients with functional MR, we observed significant changes in mitral valve anatomy with a reduction in anteroposterior diameter, valve perimeter, and area. In our cohort, the extent of those changes was greater with the use of the new-generation G4 MitraClip system compared to prior device generations.

Sections du résumé

BACKGROUND BACKGROUND
The use of mitral transcatheter edge-to-edge repair (TEER) is rapidly increasing. Anatomical changes have been described after TEER with the MitraClip system in patients with functional mitral regurgitation (MR), although no study has yet evaluated such anatomical impacts in patients treated with the G4 MitraClip generation.
METHODS METHODS
This research constituted a prospective, single-center, observational study including consecutive patients with functional MR. Mitral three-dimensional images were obtained transesophageally with echocardiography before and immediately after TEER. Patients receiving the late-generation (G4) system were compared to those receiving early-generation systems.
RESULTS RESULTS
A total of 116 functional MR patients were evaluated, and 40 (34.5%) and 76 (65.5%) received a late-generation (G4) or early-generation device system, respectively. The baseline clinical and echocardiographic features were well-balanced between the groups. Overall, there was a significant reduction in mitral annular size after the intervention, and greater reductions in the anteroposterior diameter (4 mm vs. 3.54 mm,
CONCLUSIONS CONCLUSIONS
In patients with functional MR, we observed significant changes in mitral valve anatomy with a reduction in anteroposterior diameter, valve perimeter, and area. In our cohort, the extent of those changes was greater with the use of the new-generation G4 MitraClip system compared to prior device generations.

Identifiants

pubmed: 36836021
pii: jcm12041486
doi: 10.3390/jcm12041486
pmc: PMC9964426
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Alberto Alperi (A)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, 33011 Oviedo, Spain.

Pablo Avanzas (P)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, 33011 Oviedo, Spain.
Departamento de Medicina, University of Oviedo, 33003 Oviedo, Spain.

Javier Martinez (J)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.

Antonio Adeba (A)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.

Iria Silva (I)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.

Victor Leon (V)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.

Paula Antuna (P)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.

Daniel Hernández-Vaquero (D)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, 33011 Oviedo, Spain.
Departamento de Medicina, University of Oviedo, 33003 Oviedo, Spain.

Noemi Barja (N)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.

Félix Fernández (F)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.

Cesar Moris (C)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, 33011 Oviedo, Spain.
Departamento de Medicina, University of Oviedo, 33003 Oviedo, Spain.

Isaac Pascual (I)

Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, ISPA, 33011 Oviedo, Spain.
Departamento de Medicina, University of Oviedo, 33003 Oviedo, Spain.

Classifications MeSH