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. 2021 Sep;38(9):1514-1523.
doi: 10.1111/echo.15158. Epub 2021 Jul 22.

Severe mitral regurgitation recurrence after successful percutaneous mitral edge-to-edge repair by Mitraclip in primary mitral regurgitation: Insights from a three-dimensional echocardiography study

Yoan Lavie-Badie  1   2   3   4 , Fabien Vannier  1   3   4 , Eve Cariou  1   3   4 , Pauline Fournier  1   3   4 , Romain Itier  1   3   4   5 , Stéphanie Cazalbou  1   3   4 , Virginie Blanchard  1   2   3   4   5 , Michel Galinier  1   3   4   5 , Didier Carrié  1   3   4   5 , Olivier Lairez  1   2   3   4   5 , Fréderic Bouisset  1   3 , Thibault Lhermusier  1   3   5
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Severe mitral regurgitation recurrence after successful percutaneous mitral edge-to-edge repair by Mitraclip in primary mitral regurgitation: Insights from a three-dimensional echocardiography study

Yoan Lavie-Badie et al. Echocardiography. 2021 Sep.

Abstract

Background: The sustainability of the results of Mitraclip procedures is a source of concern.

Aims: To investigate risk factors of severe mitral regurgitation (MR) recurrence after Mitraclip in primary MR.

Methods and results: Eighty-three patients undergoing successful Mitraclip procedures were retrospectively included. Valve anatomy and Mitraclips placement were comprehensively analyzed by post-processing 3D echocardiographic acquisition. The primary composite endpoint was the recurrence of severe MR. The average age was 83±7 years-old, 37 (44%) were female. Median follow-up was 381 days (IQR 195-717) and 17 (20%) patients reached the primary endpoint. Main causes of recurrence of severe MR were relapse of a prolapse (64%) and single leaflet detachment (23%). Posterior coaptation line length (HR 1.06 95%CI 1.01-1.12 p = 0.02), poor imaging quality (HR 3.84, 95%CI 1.12-13.19; p = 0.03), and inter-clip distance (HR 1.60, 95%CI 1.27-2.02; p < 0.01) were associated with the occurrence of the primary endpoint.

Conclusions: Recurrence of severe MR after a MitraClip procedure for primary MR results from a complex interplay between anatomical (tissue excess) and procedural criteria (quality of ultrasound guidance and MitraClips spacing).

Keywords: Three-dimensional echocardiography; mitral regurgitation; percutaneous intervention.

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References

REFERENCES

    1. Iung B. A prospective survey of patients with valvular heart disease in Europe: the euro heart survey on valvular heart disease. Eur Heart J. 2003;24:1231-1243.
    1. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368:1005-1011.
    1. Grayburn PA, Foster E, Sangli C, et al. Relationship between the magnitude of reduction in mitral regurgitation severity and left ventricular and left atrial reverse remodeling after MitraClip therapy. Circulation. 2013;128:1667-1674.
    1. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2017;38:2739-2791.
    1. Mirabel M, Iung B, Baron G, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?. Eur Heart J. 2007;28:1358-1365.

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