荷兰目前在MitraClip技术方面的经验、安全性及可行性。

Current MitraClip experience, safety and feasibility in the Netherlands.

作者信息

Rahhab Z, Kortlandt F A, Velu J F, Schurer R A J, Delgado V, Tonino P, Boven A J, Van den Branden B J L, Kraaijeveld A O, Voskuil M, Hoorntje J, van Wely M, van Houwelingen K, Bleeker G B, Rensing B, Kardys I, Baan J, Van der Heyden J A S, Van Mieghem N M

机构信息

Department of Cardiology, Thorax center, Erasmus Medical Center, Rotterdam, The Netherlands.

Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.

出版信息

Neth Heart J. 2017 Jun;25(6):394-400. doi: 10.1007/s12471-017-0992-1.

DOI:10.1007/s12471-017-0992-1

PMID:28444570

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5435624/

Abstract

PURPOSE

Data on MitraClip procedural safety and efficacy in the Netherlands are scarce. We aim to provide an overview of the Dutch MitraClip experience.

METHODS

We pooled anonymised demographic and procedural data of 1151 consecutive MitraClip patients, from 13 Dutch hospitals. Data was collected by product specialists in collaboration with local operators. Effect on mitral regurgitation was intra-procedurally assessed by transoesophageal echocardiography. Technical success and device success were defined according to modified definitions of the Mitral Valve Academic Research Consortium (MVARC).

RESULTS

Median age was 76 (interquartile range 69-82) years and 59% were males. Patients presented with ≥moderate mitral regurgitation and a predominance of functional mitral regurgitation (72%). Overall, 611 (53%) patients were treated with one Clip, 486 (42%) with ≥2 Clips and 54 (5%) received no Clip. The number of patients with ≥2 Clips increased from 22% in 2009 to 52% in 2016. Device success and technical success were 91 and 95%, respectively, and were consistent over the years. Significant reduction of mitral regurgitation by MitraClip was achieved in 94% of patients and was observed more often in patients with functional mitral regurgitation (95% vs. 91%, p = 0.025). Device time declined from 145 min in 2009 to 55 min in 2016.

CONCLUSION

MitraClip experience in the Netherlands is growing with excellent technical success and device success. Over the years, device time decreased and more patients were treated with ≥2 Clips.

摘要

目的

荷兰关于MitraClip手术安全性和有效性的数据稀缺。我们旨在概述荷兰的MitraClip使用经验。

方法

我们汇总了来自荷兰13家医院的1151例连续接受MitraClip治疗患者的匿名人口统计学和手术数据。数据由产品专家与当地操作人员合作收集。术中通过经食管超声心动图评估对二尖瓣反流的影响。技术成功和器械成功根据二尖瓣学术研究联盟（MVARC）的修改定义来界定。

结果

患者中位年龄为76岁（四分位间距69 - 82岁），59%为男性。患者表现为≥中度二尖瓣反流，且以功能性二尖瓣反流为主（72%）。总体而言，611例（53%）患者使用1个夹子进行治疗，486例（42%）使用≥2个夹子，54例（5%）未使用夹子。使用≥2个夹子的患者数量从2009年的22%增至2016年的52%。器械成功率和技术成功率分别为91%和95%，且多年来保持一致。94%的患者通过MitraClip实现了二尖瓣反流的显著减少，在功能性二尖瓣反流患者中更常观察到这种情况（95%对91%，p = 0.025）。器械操作时间从2009年的145分钟降至2016年的55分钟。