Short-term clinical efficacy of transcatheter edge-to-edge repair for mitral regurgitation.

Abstract

Objectives: To study the clinical effect of transcatheter edge-to-edge repair in the treatment of moderate to severe mitral regurgitation.

Methods: Clinical data of patients with moderate to severe mitral regurgitation who underwent transcatheter edge-to-edge repair (TEER) in the Department of Cardiology, the First Affiliated Hospital of Xi'an Jiaotong University from April 2021 to May 2024, were retrospectively analyzed. Preoperative baseline clinical and echocardiography data, intraoperative data and 6 months postoperatively follow-up data were collected.

Results: A total of 67 patients (47 males and 20 females) were enrolled, among whom 62 were followed up for 6 months postoperatively. The immediately postoperative success rate was 88.1% (59/67), and 83.9% (52/62) patients had mitral regurgitation 2+ and below 6 months after operation, both were significant improved compared with preoperative(P<0.05). The proportion of mitral regurgitation 2+ and below in the degenerative mitral regurgitation (DMR) group was higher than that of functional mitral regurgitation (FMR) group at 6 months postoperatively (P<0.05). The mean mitral valve gradient (MVG) in DMR group was increased from (3.1±1.2) mmHg (1 mmHg=0.133 kPa) to (3.7±1.2) mmHg 6 months after operation (P<0.05), while there was no significant change in FMR group (P>0.05). Compared with those before operation, the N-terminal pro-B-type natriuretic peptide levels on both FMR and DMR groups were significantly lower at 6 months postoperatively (all P<0.05), and the left atrial volume index and left atrial anteroposterior diameter were significantly also lower (all P<0.05). The left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly reduced 6 months after operation in the FMR group (all P<0.05), but no significant change was observed in the DMR group (all P>0.05). The ejection fraction was not significantly changed before and after operation in both groups (all P>0.05). The mitral regurgitation, tricuspid regurgitant, and pulmonary artery pressure were significantly reduced in both groups at 6 months postoperatively (all P<0.05).

Conclusions: The transcatheter edge-to-edge repair of mitral valve is effective for the treatment of moderate to severe mitral regurgitation, and improvements in left ventricular remodeling are more pronounced in patients with FMR, but the increase of MVG at 6 months postoperatively in DMR is more frequent, therefore it need long-term follow-up.