Initial French experience of percutaneous mitral valve repair with the MitraClip: a multicentre national registry

Xavier Armoiry, Eric Brochet, Thierry Lefevre, Patrice Guerin, Nicolas Dumonteil, Dominique Himbert, Bertrand Cormier, Nicolas Piriou, Mathieu Gautier, David Messika-Zeitoun, Mauro Romano, Gilles Rioufol, Karine Warin Fresse, Nicolas Boudou, Florence Leclercq, Marc Bedossa, Jean-François Obadia
Archives of Cardiovascular Diseases 2013, 106 (5): 287-94

BACKGROUND: Percutaneous mitral valve repair (MVR) using the MitraClip(®) is a new option for severe mitral regurgitation (MR).

AIM: To describe initial French experience regarding short-term and mid-term safety and efficacy.

METHODS: A multicentre cohort reported experience of percutaneous MVR using the MitraClip(®) in French centres from December 2010 to September 2012. All patients were judged inoperable or at high surgical risk. Short-term and mid-term safety and efficacy results are presented.

RESULTS: Sixty-two patients (72.7±11.4years; 71.7% men; 81.0% New York Heart Association [NYHA] class III or IV; logistic Euroscore 18.7±13.1%; 93.3% MR≥grade 3; 73.8% secondary MR) underwent percutaneous MVR using the MitraClip(®) under general anaesthesia. Procedural success was 95.2% (83.1% of patients received one clip; 16.9% received two clips). At discharge, 88.2% of implanted patients had a residual MR≤grade 2. Transthoracic echocardiography showed a significant decrease in ejection fraction (39.9±14.8% pre vs. 36.2±14.3% post), end-diastolic diameter (63.8±10.6mm vs. 61.4±12.3mm, respectively) and systolic pulmonary pressure (52.1±13.9mmHg vs. 44.7±10.9mmHg, respectively). The in-hospital mortality rate was 3.2%. The survival rate at 6-month follow-up was estimated at 83.1%, with 90.9% of patients in NYHA class I or II and residual MR≤grade 2 in 80% of cases.

CONCLUSION: This initial French experience, despite being in its learning phase, showed promising results in patients considered ineligible for surgery, as observed in more experienced centres. Randomized studies are mandatory to confirm these preliminary data.

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