Transcatheter edge-to-edge repair following surgical valve repair with ring implantation: Results from the multicentre “Clip-in-Ring” registry - 10/11/22
, Vincent Auffret a, Daniel Grinberg b, Robin Le Ruz c, Christophe Saint Etienne d, Romain Pierrard e, Didier Champagnac f, Thomas Benard g, Guillaume Lecoq h, Marc Antoine Arnould i, Guillaume Bonnet j, Thibault Lhermusier k, Amedeo Anselmi l, Hervé Corbineau l, Erwan Donal afor the
“Clip-in-Ring” registry investigators
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Graphical abstract |
Central Illustration. The “Clip-in-Ring” registry: 23 transcatheter edge-to-edge mitral valve repairs (TEERs) with ring implantation in 11 French centres. MR: mitral regurgitation; MVARC: Mitral Valve Academic Research Consortium; NYHA: Hew York Heart Association. aData are on 21 patients, because the two patients who required unplanned surgery within the first month after the procedure were not taken into account.
Highlights |
• | TEER after failed mitral valve repair is uncommon. |
• | TEER is a safe and efficient procedure after failed mitral valve repair. |
• | The role of TEER after failed mitral valve repair needs to be clarified. |
Abstract |
Background |
Management of mitral regurgitation recurrence after failed surgical valve repair with ring implantation is controversial.
Aim |
To describe the French experience regarding midterm safety and efficacy of transcatheter edge-to-edge mitral valve repair (TEER) in patients with failed surgical valve repair with ring implantation.
Methods |
The “Clip-in-Ring” registry is a multicentre registry conducted in 11 centres in France, approved by local institutional review boards, of consecutive TEER following surgical valve repair with ring implantation. Outcomes were Mitral Valve Academic Research Consortium (MVARC) technical success, modified 30-day device and procedural success (where 10mmHg is considered as a cut-off for significant mitral stenosis) and MVARC complications.
Results |
Twenty-three patients were studied: mean age, 69±10years; male sex, 74%; EuroSCORE II, 16±17; left ventricular ejection fraction, 53±12%; mitral regurgitation grade 3+/4+, 17%/78%; New York Heart Association class III/IV, 47%/22%; median surgery to TEER delay, 23 (6–94) months. Technical success was 100%. At discharge, residual mitral regurgitation grade was≤2+ in 87% and median transmitral gradient was 4 (3–5) mmHg. Thirty-day modified MVARC device and procedural success was 82%: four patients (17%) had residual mitral regurgitation grade>2+, including two patients who needed complementary surgery. No patient had a 30-day transmitral gradient>7mmHg. No patient died or had a stroke or any life-threatening complications. One patient presented a vascular access complication requiring transfusion. No other MVARC-2 adverse event was reported.
Conclusions |
TEER in patients with failed mitral ring is feasible and safe. Further studies should delineate its exact role in the therapeutic armamentarium for this medical issue.
Le texte complet de cet article est disponible en PDF.Keywords : Mitral regurgitation, Transcatheter edge-to-edge repair, MitraClip, Surgical valve repair, Registry
Abbreviations : IQR, MR, MV, MVARC, NYHA, STS, TEER
Plan
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Vol 115 - N° 10
P. 521-528 - octobre 2022 Retour au numéro
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