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The aim of this study was to evaluate the procedural success and early outcomes of MitraClip implantation.
Between July 2012 and February 2013, 15 patients (12 males, 3 females; mean age 60.80±13.03; range from 35 to 78 years old) underwent MitraClip implantation in our clinic were included. All patients had symptomatic severe functional mitral regurgitation with high surgical risk or were judged to be inoperable by heart team.
The success of the procedure was 93.33%. We have successfully implanted MitraClip device to all patients except one. One clip was implanted in 9 (64.28%) patients, and 5 (35.71%) patients were treated with 2 clips. The mean procedure time was 183.84±80.96 minutes (range, 90–300 minutes), with a mean septal puncture time of 36.15±32.09 minutes. Following the procedure, severity of the mitral regurgitation was decreased average 2.10±0.48 grade. Average functional status of the patients improved from NYHA class 3.86±0.35 to 2.58±0.79 at 1 month follow up. Their 6-minute walking distances improved from 276.16±150.71 to 378.00±168.40 meters. N terminal B-type natriuretic peptide levels decreased from 3642.26±3220.01 to 2025.80±810.34 pg/ml. 2 patients (13.33%) died within the first month of follow-up due to noncardiac causes.
The MitraClip procedure can be performed safely to the symptomatic patients with severe functional mitral regurgitation who have otherwise high surgical risk or are judged to be inoperable. Our initial experience demonstrated acute echocardiographic and early clinical improvement in these patients.
|Coaptation length||> 2 mm|
|Mobile posterior leaflet|
|Posterior leaflet length||> 8 mm|
|No leaflet calcification on grasping site|
|Leaflet thickness||<5 mm|
|Mitral valve orifice area||>4 cm2|
|Rheumatic valve disease|
|Thick interatrial septum|
|Active infective endocarditis|
|Flail leaflet (not an exclusion criteria if flail gap<10 mm and flail width< 15 mm)|
|Presence of cleft|
|Age, years||60.80 ± 13,03|
|Age >65 years, (%)||6 (40.0)|
|Male sex, (%)||12 (80.0)|
|Hypertension, (%)||6 (40.0)|
|Diabetes mellitus, (%)||5 (33.3)|
|eGFR, ml/min per 1.73 m2||57.66±16.66|
|History of coronary artery disease, (%)||11 (73.3)|
|EF, %||28.73 ± 8.75|
|NT-Pro BNP, pg/ml||3642.26 ± 3220.01|
|LV end-diastolic diameter, mm||64.85±9.28|
|LV end-systolic diameter, mm||54.78±10.82|