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Erschienen in: Wiener klinische Wochenschrift 5-6/2018

04.12.2017 | original article

Initial Slovenian experience with MitraClip therapy

Careful selection of patients is crucial for optimal outcome

verfasst von: Jana Ambrožič, Marta Cvijič, Mojca Bervar, Špela Mušič, Matjaž Bunc

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 5-6/2018

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Summary

Background

MitraClip is a percutaneous mitral repair technology increasingly used for high surgical risk patients with primary or secondary mitral regurgitation. We describe initial Slovenian experience with MitraClip and discuss the importance of identifying the suitable candidates for this procedure.

Methods

We retrospectively analyzed the first 10 patients (mean age 75.6 ± 6.9 years, logistic Euroscore 28.4 ± 10.9%) with severe and moderate to severe mitral regurgitation (8 secondary, 1 primary and 1 mixed etiology) who underwent a MitraClip procedure between January 2015 and February 2017.

Results

Acute reduction of mitral regurgitation was achieved in all but one patient (90%). There were no periprocedural mortalities and at short to mid-term follow-up (median 12 months, interquartile range 3–15 months). In eight patients improvement of functional class was observed at discharge. No functional improvement was achieved in a patient with advanced ischemic cardiomyopathy, and in a patient with degenerative mitral disease in whom the MitraClip procedure had failed necessitating mitral valve surgery. One patient experienced late leaflet detachment and was effectively managed with a second MitraClip procedure. There were two vascular complications at the access site and one percutaneous closure of an iatrogenic atrial septal defect.

Conclusion

Our initial experiences with a small number of patients indicate that percutaneous mitral repair with MitraClip is a feasible and safe method in high-risk patients. Special attention should be paid to careful patient selection including detailed echocardiographic evaluation of mitral valve anatomy, technical performance and final result, particularly at the beginning of the learning curve in order to reduce the rate of serious complications.
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Metadaten
Titel
Initial Slovenian experience with MitraClip therapy
Careful selection of patients is crucial for optimal outcome
verfasst von
Jana Ambrožič
Marta Cvijič
Mojca Bervar
Špela Mušič
Matjaž Bunc
Publikationsdatum
04.12.2017
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 5-6/2018
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-017-1295-7