Percutaneous Edge-to-Edge Mitral Valve Repair in High-Surgical-Risk Patients

摘要: Objectives This study sought to assess the feasibility and safety of percutaneous edge-to-edge mitral valve (MV) repair in patients with an unacceptably high operative risk. Background MV for regurgitation (MR) can be accomplished by use a clip that approximates free edges leaflets. Methods All were declined surgery because logistic EuroSCORE (>20%) or presence other specific surgical risk factors. Transthoracic echocardiography was performed before 6 months after procedure. Differences New York Heart Association (NYHA) functional class, quality life (QoL) using Minnesota questionnaire, 6-min walk test (6-MWT) distances reported. Results Fifty-five procedures 52 (69.2% male, age 73.2 ± 10.1 years, 27.1 17.0%). In 3 patients, partial detachment occurred; second placed successfully. One patient experienced cardiac tamponade. Two developed inguinal bleeding, whom 1 needed surgery. Six (11.5%) died during 6-month follow-up (5 as result progressive heart failure noncardiac death). The MR grade ≥3 100%; months, reduction ≤2 present 79% patients. Left ventricular (LV) end-diastolic diameter, LV ejection fraction, systolic pulmonary artery pressure improved significantly. Accompanied improvements NYHA QoL index, 6-MWT distances, log N-terminal pro–B-type natriuretic peptide observed. Conclusions high-risk population, achieved repair, resulting remodeling improvement capacity months.