2024 Volume 6 Issue 1 Pages 17-24
Objective: Transcatheter edge-to-edge repair (TEER) using MitraClip (Abbott, Abbott Park, IL, USA) is a less invasive treatment for patients with mitral regurgitation (MR) than mitral valve surgery. Treatment strategies for degenerative MR tend to be individually influenced by the anatomical characteristics of the lesion and patient background, and the middle- to long-term clinical outcomes of TEER with MitraClips, including the fourth-generation (G4) system, are unclear. This study aimed to evaluate the middle-term clinical outcomes of TEER for degenerative MR based on actual clinical practice.
Methods: Patients who underwent TEER for degenerative MR at our institution, including those who could be followed up for up to 3 years, were enrolled. The primary endpoints were all-cause mortality and hospitalization for heart failure after TEER for degenerative MR with the MitraClip second-generation (G2) and G4 systems.
Results: The subjects were 26 consecutive patients undergoing TEER for degenerative MR between June 2019 and December 2022 at our institution. Sixteen patients underwent TEER with the MitraClip G2 system (61.5%), and ten patients underwent TEER with the G4 system (38.5%). Twenty-five patients (96.2%) achieved acute procedural success defined as an MR severity grade of 2+ or less at the time of discharge. All patients underwent the procedure without major complications, and mortality at 30 days was 0%. At 3 years, the percentages of patients with freedom from all-cause mortality and hospitalization for heart failure were 82.1% and 83.7%, respectively.
Conclusion: Excellent procedural outcomes and acceptable freedom from all-cause mortality and hospitalization for heart failure at 3 years were observed in 26 consecutive cases of TEER for degenerative MR at our institution. Our results show that TEER is a feasible and effective treatment for high-risk patients undergoing mitral valve surgery for degenerative MR.
