Heart Institute, Apollo Hospitals, Greams road, Chennai, India.
Heart Institute, Apollo Hospitals, Greams road, Chennai, India.
Indian Heart J. 2024 Sep-Oct;76(5):315-320. doi: 10.1016/j.ihj.2024.09.002. Epub 2024 Sep 28.
To evaluate the outcomes of transcatheter edge-to-edge repair (TEER) with MitraClip™ (Abbott Vascular) in symptomatic high surgical risk Indian patients with significant mitral regurgitation (MR).
Patients with moderately severe or severe primary or secondary MR and deemed high surgical risk were treated with MitraClip™. The data were collected retrospectively from medical records. The primary outcome was technical success, and secondary outcomes were ≤2+ MR reduction and improvement in functional capacity at 30 days.
Between November 2018 and August 2023, 64 patients were treated with MitraClip. The mean age was 70.0 ± 12.1 years and 64 % were males. The mean EuroScore II and STS score predicted mortality for mitral valve repair were 5.8 ± 4.5 % and 4.0 ± 3.8 % respectively. MR etiology was primary in 56.3 %, secondary in 40.6 % and mixed in 3.1 %. The device was implanted successfully in all but one patient with technical success rate of 98.4 %. The average number of clips per patient was 1.5 ± 0.6 and 42.2 % patients received more than one clip. The mean mitral valve gradient was 3.5 ± 1.6 mmHg. The MR severity of ≤2+ was achieved in 91.8 % of the subjects and similar proportion were in New York Heart Association Functional Class I or II at 30 days.
In high-risk Indian patients with symptomatic significant MR, TEER with MitraClip™ was achieved with a high technical success rate. It was associated with significant reduction in MR severity and improvement in functional capacity in >90 % of the subjects.
评估经导管缘对缘修复(TEER)联合 MitraClip™(雅培血管)在印度高危症状性重度二尖瓣反流(MR)患者中的应用效果。
对中度或重度原发性或继发性 MR 且手术风险高的患者采用 MitraClip™ 进行治疗。从病历中回顾性收集数据。主要转归为技术成功,次要转归为 30 天时 MR 减少至≤2+及功能容量改善。
2018 年 11 月至 2023 年 8 月,共 64 例患者接受了 MitraClip 治疗。患者平均年龄为 70.0±12.1 岁,64%为男性。EuroScore II 和 STS 评分分别预测二尖瓣修复的死亡率为 5.8±4.5%和 4.0±3.8%。MR 的病因原发性占 56.3%,继发性占 40.6%,混合性占 3.1%。除 1 例患者因技术原因未植入设备外,其余患者均成功植入,技术成功率为 98.4%。每位患者的平均夹数量为 1.5±0.6 个,42.2%的患者接受了超过 1 个夹子。平均二尖瓣瓣间梯度为 3.5±1.6mmHg。91.8%的患者达到了 MR 严重程度≤2+,30 天时相同比例的患者纽约心脏协会心功能分级为 I 或 II 级。
在高危印度症状性重度 MR 患者中,TEER 联合 MitraClip™ 治疗具有较高的技术成功率,可显著降低 MR 严重程度,90%以上的患者功能容量得到改善。