Mitraclip after failed surgical mitral valve repair—an international multicenter study

Zouhair Rahhab, David Scott Lim, Stephen H. Little, Maurizio Taramasso, Shingo Kuwata, Matteo Saccocci, Corrado Tamburino, Carmelo Grasso, Christian Frerker, Theresa Wißt, Ross Garberich, Jörg Hausleiter, Daniel Braun, Eleonora Avenatti, Victoria Delgado, Gian Paolo Ussia, Fausto Castriota, Roberto Nerla, Hüseyin Ince, Alper ÖnerRodrigo Estevez-Loureiro, Azeem Latib, Damiano Regazzoli, Nicolo Piazza, Hind Alosaimi, Peter P.T. de Jaegere, Jeroen Bax, Danny Dvir, Francesco Maisano, Paul Sorajja, Michael J. Reardon, Nicolas M. Van Mieghem*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
8 Downloads (Pure)

Abstract

BACKGROUND: Recurrence of mitral regurgitation (MR) after surgical mitral valve repair (SMVR) varies and may require reoperation. Redo mitral valve surgery can be technically challenging and is associated with increased risk of mortality and morbidity. We aimed to assess the feasibility and safety of MitraClip as a treatment strategy after failed SMVR and identify procedure modifications to overcome technical challenges. METHODS AND RESULTS: This international multicenter observational retrospective study collected information for all patients from 16 high-volume hospitals who were treated with MitraClip after failed SMVR from October 29, 2009, until August 1, 2017. Data were anonymously collected. Technical and device success were recorded per modified Mitral Valve Academic Research Consortium criteria. Overall, 104 consecutive patients were included. Median Society of Thoracic Surgeons score was 4.5% and median age was 73 years. At baseline, the majority of patients (82%) were in New York Heart Association class ≥III and MR was moderate or higher in 86% of patients. The cause of MR pre-SMVR was degenerative in 50%, functional in 35%, mixed in 8%, and missing/unknown in 8% of patients. The median time between SMVR and MitraClip was 5.3 (1.9–9.7) years. Technical and device success were 90% and 89%, respectively. Additional/modified imaging was applied in 21% of cases. An MR reduction of ≥1 grade was achieved in 94% of patients and residual MR was moderate or less in 90% of patients. In-hospital all-cause mortality was 2%, and 86% of patients were in New York Heart Association class ≤II. CONCLUSIONS: MitraClip is a safe and less invasive treatment option for patients with recurrent MR after failed SMVR. Additional/ modified imaging may help overcome technical challenges during leaflet grasping.

Original languageEnglish
Article numbere019236
JournalJournal of the American Heart Association
Volume10
Issue number7
DOIs
Publication statusPublished - 6 Apr 2021

Bibliographical note

Funding Information:
Lim reports that his institution receives research grants from Abbott Vascular and Edwards Lifesciences, and he reports personal consulting income from Abbott Vascular and Edwards Lifesciences. Hausleiter reports that his institution receives research grants from Abbott Vascular and Edwards Lifesciences, and he received speaker honoraria from Abbott Vascular and Edwards Lifesciences and serves as a consultant for both companies. Taramasso is a consultant for Abbott, Boston Scientific, 4tech, and CoreMedic; reports personal fees from Edwards and CardioValve; and is on the advisory board for Abbott. Estevez-Loureiro is consultant for Abbott Vascular. Delgado received speaker fees from Abbott Vasculer, Edwards Lifesciences, GE Healthcare, and Medtronic. Bax received speaker fees from Abbott Vascular. The Department of Cardiology of the Leiden University Medical Center received grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. Maisano reports grant and/or research support from Abbott, Medtronic, Edwards Lifesciences, Biotronik, Boston Scientific Corporation, NVT, and Terumo; consulting fees/honoraria from Abbott, Medtronic, Edwards Lifesciences, Swissvortex, Perifect, Xeltis, Transseptal solutions, Cardiovalve, and Magenta; royalty income/IP rights from Edwards Lifesciences; and is a shareholder of Cardiovalve, Cardiogard, Magenta, SwissVortex, Transseptalsolutions, Occlufit, 4Tech, and Perifect. Sorajja reports personal fees from Abbott Structural; personal fees from Medtronic, Boston Scientific, Edwards, Admedus, Gore, and Teleflex, outside of the submitted work. Piazza is proctor for HighLife and is a steering committee member of Medtronic’s Apollo Trial. Van Mieghem reports research grant support and advisory fees from Abbott, Boston Scientific, and Medtronic. Little reports personal fees from Abbott Structural Heart and Medtronic Structural Heart, outside of the submitted work. Latib reports personal fees from Medtronic, Abbott Vascular, and Edwards Lifesciences, outside of the submitted work. Castriota reports personal fees from Abbott Vascular, outside of the submitted work. Braun reports speaker honoraria from Abbott Vascular. The remaining authors have no disclosures to report.

Publisher Copyright:
© 2021 The Authors.

Fingerprint

Dive into the research topics of 'Mitraclip after failed surgical mitral valve repair—an international multicenter study'. Together they form a unique fingerprint.

Cite this