Promising results after percutaneous mitral valve repair.

Abstract

Introduction: Mitral valve regurgitation (MR) is the secondmost frequent valve disease in Europe. Untreated MR causes considerable morbidity and mortality. In the elderly, as many as half of these patients are denied surgery because of an estimated high surgical risk. Percutaneous mitral valve repair with the MitraClip system resembles the Alfieristitch where a clip is used to connect the tip of the mitral valve leaflets.

Material and methods: Sixteen patients with MR of various origins (functional/degenerative) were treated with the MitraClip system. All patients were highly symptomatic with dyspnoea (New York Heart Association (NYHA) grade three) and MR grade three or more, and had been turned down for surgery due to an excessively high risk.

Results: MR was reduced in all but one patient, generally from grade 3.5±0.5 to grade 1.4±0.9. A total of four patients (25%) received two clips. Thirty-day complications were as follows: one patient died, one had a stroke (speech sequelae), one patient had a new chord rupture that was treated surgically. During 90 days of follow-up, symptoms of dyspnoea diminished (reduction of 1 NYHA grade) and the 6-minute walk test results improved from 171±99 to 339±134 metres (p<0.001).

Conclusion: Percutaneous mitral valve repair with the MitraClip system is now available in Denmark. The treatment is a reasonable alternative in patients with MR and a high estimated surgery risk.

Funding: Not relevant.

Trial registration: Not relevant.