Percutaneous Mitral Valve Repair: Outcome Improvement with Operator Experience and a Second-Generation Device

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Percutaneous mitral valve repair (PMVR) outcomes are influenced by device generation and operator experience.
• Previous studies suggest a learning curve for PMVR, impacting patient selection and procedural success.

Purpose of the Study:

• To compare clinical outcomes of PMVR using the second-generation Mitraclip NT system versus the first-generation system.
• To evaluate the impact of device evolution on procedural success and patient safety in functional mitral regurgitation (FMR).

Main Methods:

• A multicenter study collected data from 545 patients undergoing PMVR between 2012 and 2017.
• Patients were divided into three groups: first-generation Mitraclip (control-1, control-2) and second-generation Mitraclip NT.
• Outcomes assessed included procedural success, major adverse events, and a composite endpoint of death, surgery, or heart failure admission at 12 months.

Main Results:

• Procedural success rates were high (93.3%) and similar across all groups.
• The Mitraclip NT group showed a significantly lower rate of the composite endpoint (8.3%) compared to control groups (23.5% and 22.5%).
• A higher incidence of pericardial effusion was observed in the control-1 group.

Conclusions:

• Contemporary PMVR with the Mitraclip system demonstrates improved clinical outcomes over time.
• The second-generation Mitraclip NT device is associated with better patient outcomes in FMR compared to earlier systems.