The acute effects of edge-to-edge percutaneous mitral valve repair on the shape and size of the mitral annulus and its relation to mitral regurgitation

摘要

Background The effects of edge-to-edge percutaneous mitral valve repair on the shape and size of the mitral annulus and its relation to mitral regurgitation (MR) have not been well characterized. We evaluated acute changes in mitral annular shape and dimensions, and their effect on MR severity, in patients with functional and degenerative MR following MitraClipA (R). Methods Patients that underwent MitraClipA (R) between January 2013 and May 2016 at our institution were retrospectively reviewed. Exclusions: inadequate images, prior mitral valve repair, and rapid atrial fibrillation. Intra-procedure TEE 3D images acquired prior to and after implantation of MitraClipA (R) were analyzed using software to model the mitral valve apparatus. Results Of seventy-eight patients that underwent MitraClipA (R) procedure, 60 were eligible. Mean age was 78.3 +/- 11 years. Severe MR (4+) was present in 37 patients, moderately/severe MR (3+) in 23. All patients achieved MR reduction to <= 2. 3D annular circumference, bicommissural diameter, and anteroposterior diameter had a significant size reduction after MitraClipA (R). None of the mitral annular measures had significantly different mean change between the large and small MR change groups at the 0.05 significance level. Conclusions In patients with functional or degenerative MR, the MitraClipA (R) significantly affect mitral annular dimensions; however, these changes do not correlate with the immediate MR reduction.