Transcatheter Edge-to-Edge Mitral Valve Repair With the MitraClip G4 System

• Published in: JACC. Cardiovascular interventions 2020-10, Vol.13 (20), p.2402-2414
• Main Authors: Chakravarty, Tarun, Makar, Moody, Patel, Dhairya, Oakley, Luke, Yoon, Sung Han, Stegic, Jasminka, Singh, Siddharth, Skaf, Sabah, Nakamura, Mamoo, Makkar, Raj R.
• Format: Article
• Language: English
• Subjects: MitraClip G4; mitral regurgitation
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2020.06.053

The primary objective of this study was to evaluate the effectiveness of the MitraClip G4 in the reduction of mitral regurgitation (MR). The next-generation MitraClip G4 system was recently introduced for the treatment of MR in the United States. The study included consecutive patients undergoing transcatheter mitral edge-to-edge repair for MR with the MitraClip G4. The key outcome was the proportion of patients with MR reduction to ≤2+ at 30 days. Fifty-nine patients (median age 77 years, 62.7% men) were treated with the MitraClip G4. Reduction of MR to ≤2+ was achieved in 57 patients (96.6%) during the procedure, 58 patients (98.3%) at discharge, and 57 patients (96.6%) by 30 days. The median number of MitraClips used per patient was 2 (interquartile range: 1 to 3). Wide clips (NTW/XTW) were used in 82.7% of patients. The XTW clip was used most frequently as the first clip in patients with degenerative MR (65.4%) and the NTW clip in those with secondary MR (72.7%). The independent grasping mechanism was used in 49.2% of patients. Use of the MitraClip G4 system was associated with excellent reduction in MR to ≤2+ in 96.6% of patients at 30 days. The availability of multiple MitraClip G4 sizes, especially the wide clips, and the ability to independently grasp leaflets are the likely contributors to MR reduction. [Display omitted]