Transcatheter edge-to-edge mitral valve repair in patients with severe mitral regurgitation. (The first Russian experience of one-year follow-up)

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OBJECTIVE

To evaluate the results of transcatheter edge-to-edge mitral valve repair in high risk patients with degenerative and functional mitral regurgitation in early and long-term follow-up period.

MATERIAL AND METHODS

A prospective study enrolled 43 patients (median age 73 years [64; 82]) including 23 ones with secondary mitral regurgitation and 20 ones with primary mitral regurgitation between 2020 and 2021. Transcatheter edge-to-edge mitral valve repair with implantation of second-generation clips was performed. All patients underwent transthoracic and transesophageal echocardiography at baseline, 4—5 days, 6 and 12 months after intervention. We analyzed quantitative parameters of mitral regurgitation, left ventricular remodeling and central hemodynamics.

RESULTS

Immediate technical success was observed in all patients. One patient died early after surgery. Overall mortality throughout 16-month follow-up was 16.3% (n=7), 11 (25.6%) patients admitted within a year for cardiovascular events. Mitral regurgitation significantly decreased after 12 months in both cohorts of patients (from 3.7±0.54 to 2.4±0.68 for primary mitral regurgitation, p=0.039; from 3.3±0.45 to 2.2±0.56 for secondary mitral regurgitation; p<0.001). After a year, 86% of patients had mild-to-moderate mitral regurgitation. Reverse LV remodeling was achieved in both groups with significant differences for primary mitral regurgitation. Indeed, left ventricular end-diastolic volume decreased from 140 [102; 163] to 102 [88; 140] ml (p=0.013), left atrium (LA) volume — from 134 [114; 174] to 125 [108; 160] ml (p=0.048). In patients with secondary mitral regurgitation, LV EDV decreased from 211 [125; 222] to 196 [101; 234] ml (p>0.05), LA volume — from 136 [114; 154] to 123 [110; 148] ml (p>0.05).

CONCLUSION

Our data demonstrate effective correction of severe mitral regurgitation in high-risk patients throughout 12-month follow-up period.

Keywords:

mitral regurgitation

echocardiography

transcatheter mitral valve repair

MitraClip

Authors:

Saidova M.A.

Chazov National Medical Research Center for Cardiology

ORCID: 0000-0002-3233-1862

Makeev M.I.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-4779-5088

Kuchin I.V.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0001-7691-9185

Komlev A.E.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0001-6908-7472

Imaev T.E.

Chazov National Medical Research Centre of Cardiology

ORCID: 0000-0002-5736-5698

Akchurin R.S.

Chazov National Medical Research Center for Cardiology

ORCID: 0000-0002-2105-8258

Received:

26.08.2023

Accepted:

28.08.2023

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