Changes in mitral valve geometry after percutaneous valve repair with the MitraClip® System

The aim of our study was to assess the anatomical changes of the mitral valve apparatus after percutaneous repair with the MitraClip® system. We included consecutive patients who underwent MitraClip® implantation in our center. Patients were assessed by 2- and 3-dimensional transesophageal echocardiography, acquired before and immediately after MitraClip® implantation. Off-line images analysis was performed to assess mitral annular diameters (antero-posterior and inter-commisural), area and circumference. Mitral tenting distance, area and volume were evaluated for functional mitral regurgitation. Patients had a 2-dimensional transthoracic echocardiography at follow-up (8 months). 38 patients with successful results (residual mitral regurgitation grade ≤ II) were included. The anteroposterior annulus diameter (ADP) decreased (from 35 ± 5 to 28 ± 5 mm, p < 0.001) with smaller decreases in the annular area and circumference and in the inter-commissural diameter. Annular ellipticity improved. The reduction in APD and tenting distance was sustained at follow-up. Successful percutaneous mitral valve repair with the MitraClip® system induces a stable change in mitral valve geometry mainly at the ADP, suggesting a significant annuloplasty that contributes to the reduction of mitral regurgitation.