Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center Study
Background: Mitral regurgitation (MR) is a common valvular disorder linked to high morbidity and mortality. For patients unsuitable for surgery, transcatheter mitral edge-to-edge repair (TEER) with the MitraClip<sup>®</sup> G4 system offers an alternative. This study aims to evaluate pro...
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MDPI AG
2024-12-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/12/1/4 |
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| author | Georgios E. Papadopoulos Ilias Ninios Sotirios Evangelou Andreas Ioannidis Vlasis Ninios |
| author_facet | Georgios E. Papadopoulos Ilias Ninios Sotirios Evangelou Andreas Ioannidis Vlasis Ninios |
| author_sort | Georgios E. Papadopoulos |
| collection | DOAJ |
| description | Background: Mitral regurgitation (MR) is a common valvular disorder linked to high morbidity and mortality. For patients unsuitable for surgery, transcatheter mitral edge-to-edge repair (TEER) with the MitraClip<sup>®</sup> G4 system offers an alternative. This study aims to evaluate procedural, echocardiographic, functional, and quality of life (QoL) outcomes in patients who underwent TEER with the MitraClip<sup>®</sup> G4 system, along with possible predictors of New York Heart Association (NYHA) class I at 30 days and at 1 year. Methods: Patients with moderate-to-severe (3+) or severe (4+) degenerative MR (DMR) or functional MR (FMR), classified as NYHA class III or IV, and who underwent TEER with the MitraClip<sup>®</sup> G4 system at our center between January 2021 and December 2023 were included. Results: A total of 83 patients [71% FMR, 66% male, median (IQR) age 70 (11) years] underwent TEER, with 100% procedural success. MR ≤ 2+ was achieved in 100% and 98% of patients at 30 days and 1 year, respectively. NYHA class I or II was achieved in 100% and 96.8% of patients at 30 days and 1 year, respectively. The Kansas City Cardiomyopathy Questionnaire (KCCQ) score improved from 51 ± 20 at baseline to 69 ± 15 at 30 days (<i>p</i> < 0.001) and 70.5 ± 15 at 1 year (<i>p</i> < 0.001). Lower baseline N-terminal pro-brain natriuretic peptide (NT-proBNP) predicted achieving NYHA class I at 30 days (HR: 0.63, 95% CI: 0.41–0.95, <i>p</i> = 0.030), while lower European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and NT-proBNP predicted it at 1 year [(HR: 0.50, 95% CI: 0.28–0.89, <i>p</i> = 0.019), (HR: 0.67, 95% CI: 0.44–0.99, <i>p</i> = 0.049), respectively]. Conclusions: The MitraClip<sup>®</sup> G4 system provides significant improvements in MR severity, functional class, and QoL. Lower NT-proBNP and EuroSCORE II were strong predictors of achieving optimal functional status (NYHA class I). |
| format | Article |
| id | doaj-art-3ef1fe70938440e9afd72795397d8f6c |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-3ef1fe70938440e9afd72795397d8f6c2025-01-24T13:35:56ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-12-01121410.3390/jcdd12010004Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center StudyGeorgios E. Papadopoulos0Ilias Ninios1Sotirios Evangelou2Andreas Ioannidis3Vlasis Ninios42nd Cardiology Department, Interbalkan Medical Center, 55535 Thessaloniki, Greece2nd Cardiology Department, Interbalkan Medical Center, 55535 Thessaloniki, Greece2nd Cardiology Department, Interbalkan Medical Center, 55535 Thessaloniki, Greece2nd Cardiology Department, Interbalkan Medical Center, 55535 Thessaloniki, Greece2nd Cardiology Department, Interbalkan Medical Center, 55535 Thessaloniki, GreeceBackground: Mitral regurgitation (MR) is a common valvular disorder linked to high morbidity and mortality. For patients unsuitable for surgery, transcatheter mitral edge-to-edge repair (TEER) with the MitraClip<sup>®</sup> G4 system offers an alternative. This study aims to evaluate procedural, echocardiographic, functional, and quality of life (QoL) outcomes in patients who underwent TEER with the MitraClip<sup>®</sup> G4 system, along with possible predictors of New York Heart Association (NYHA) class I at 30 days and at 1 year. Methods: Patients with moderate-to-severe (3+) or severe (4+) degenerative MR (DMR) or functional MR (FMR), classified as NYHA class III or IV, and who underwent TEER with the MitraClip<sup>®</sup> G4 system at our center between January 2021 and December 2023 were included. Results: A total of 83 patients [71% FMR, 66% male, median (IQR) age 70 (11) years] underwent TEER, with 100% procedural success. MR ≤ 2+ was achieved in 100% and 98% of patients at 30 days and 1 year, respectively. NYHA class I or II was achieved in 100% and 96.8% of patients at 30 days and 1 year, respectively. The Kansas City Cardiomyopathy Questionnaire (KCCQ) score improved from 51 ± 20 at baseline to 69 ± 15 at 30 days (<i>p</i> < 0.001) and 70.5 ± 15 at 1 year (<i>p</i> < 0.001). Lower baseline N-terminal pro-brain natriuretic peptide (NT-proBNP) predicted achieving NYHA class I at 30 days (HR: 0.63, 95% CI: 0.41–0.95, <i>p</i> = 0.030), while lower European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and NT-proBNP predicted it at 1 year [(HR: 0.50, 95% CI: 0.28–0.89, <i>p</i> = 0.019), (HR: 0.67, 95% CI: 0.44–0.99, <i>p</i> = 0.049), respectively]. Conclusions: The MitraClip<sup>®</sup> G4 system provides significant improvements in MR severity, functional class, and QoL. Lower NT-proBNP and EuroSCORE II were strong predictors of achieving optimal functional status (NYHA class I).https://www.mdpi.com/2308-3425/12/1/4mitral regurgitationtranscatheter edge-to-edge repairMitraClipMR severityQoLNYHA class |
| spellingShingle | Georgios E. Papadopoulos Ilias Ninios Sotirios Evangelou Andreas Ioannidis Vlasis Ninios Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center Study Journal of Cardiovascular Development and Disease mitral regurgitation transcatheter edge-to-edge repair MitraClip MR severity QoL NYHA class |
| title | Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center Study |
| title_full | Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center Study |
| title_fullStr | Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center Study |
| title_full_unstemmed | Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center Study |
| title_short | Safety and Efficacy in Mitral Regurgitation Management with the MitraClip<sup>®</sup> G4 System: Insights from a Single-Center Study |
| title_sort | safety and efficacy in mitral regurgitation management with the mitraclip sup r sup g4 system insights from a single center study |
| topic | mitral regurgitation transcatheter edge-to-edge repair MitraClip MR severity QoL NYHA class |
| url | https://www.mdpi.com/2308-3425/12/1/4 |
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