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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

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Transcatheter edge-to-edge mitral valve repair in patients with mitral annulus calcification

Estefanía Fernández-Peregrina1,2, Isaac Pascual3, Xavier Freixa4

  • 1Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|September 6, 2021
PubMed
Abstract

Insights

Transcatheter edge-to-edge repair using MitraClip is safe and effective for patients with mitral regurgitation and mitral annulus calcification. This treatment shows good clinical and echocardiographic outcomes at one year.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Mitral annulus calcification (MAC) is common in mitral regurgitation (MR) patients, associated with poor outcomes.
  • Transcatheter edge-to-edge repair (TEER) is an alternative, but evidence in MAC patients is limited.

Purpose of the Study:

  • To evaluate the safety, efficacy, and durability of MitraClip implantation.
  • To analyze outcomes in patients with severe MR and moderate/severe MAC compared to those without/mild MAC.

Main Methods:

  • Retrospective analysis of 61 patients with MAC and 791 patients without/mild MAC undergoing MitraClip.
  • Comparison of procedural success, complication rates, and one-year clinical/echocardiographic outcomes.

Main Results:

  • Similar procedural success (91.8% MAC vs 95.1% NoMAC) and low complication rates.
  • At one year, 90.6% MAC patients had MR grade ≤2; 80% in both groups were NYHA Class ≤II.
  • Higher one-year mortality in MAC patients (19.7% vs 11.3%), with no difference in cardiovascular mortality.

Conclusions:

  • MitraClip is safe and feasible for selected patients with moderate/severe MAC and severe MR.
  • The procedure yields good clinical and echocardiographic results at one-year follow-up.
  • TEER offers a viable treatment option for this high-risk population.

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