Transcatheter Edge-to-Edge Mitral Valve Repair With the MitraClip G4 System

Chakravarty, Tarun; Makar, Moody; Patel, Dhairya; Oakley, Luke; Yoon, Sung Han; Stegic, Jasminka; Singh, Siddharth; Skaf, Sabah; Nakamura, Mamoo; Makkar, Raj

doi:10.1016/j.jcin.2020.06.053

Cited by 77 publications

(81 citation statements)

References 11 publications

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“…The fibrous encapsulation of the clip over time might stabilize the leaflet insertion, so late SLDA is a rare finding. There has been a continuous reduction in SLDA over years, which likely reflects the implanter's learning curve and advances in the clip systems: EVEREST I 11.0%, EVEREST II 5.1%, ACCESS-EU 4.8%, TRAMI 2.0%, TVT 1.5%, Praz et al 4.0%, Mitra EXPAND 1.9%, and "G4" 1.7% [5,13,14,16…”

Section: Structural Device Failurementioning

confidence: 99%

Complications Following MitraClip Implantation

et al. 2021

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Purpose of Review To provide a detailed overview of complications associated with MitraClip therapy and its development over time with the aim to alert physicians for early recognition of complications and to offer treatment strategies for each complication, if possible. Recent Findings The MitraClip system (MC) is the leading transcatheter technique to treat mitral regurgitation (MR) and has been established as a safe procedure with very low adverse event rates compared to mitral surgery at intermediate to high risk or in secondary MR. Lately, the fourth MC generation has been launched with novel technical features to facilitate device handling, decrease complication rates, and allow the treatment of even complex lesions. Summary Although the complication rate is low, adverse events are associated with increased morbidity and mortality. The most common complications are bleeding, acute kidney failure, procedure-induced mitral stenosis, and an iatrogenic atrial septal defect with unknown clinical impact.

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Section: Structural Device Failurementioning

confidence: 99%

Complications Following MitraClip Implantation

et al. 2021

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“…The MitraClip currently has a fourth-generation ‘G4’ device, which has been enhanced with an expanded range of four clip sizes (NTR, NTW, XTR, XTW), differentiated by clip arm length and width, independent leaflet grasping feature and real-time left atrial (LA) pressure monitoring capabilities. [ 19 , 20 ] The G4 system is already available in parts of Asia and these new features could aid in the treatment of challenging anatomies.…”

Section: Mitraclip Use In Functional Mitral Regurgitationmentioning

confidence: 99%

Asian Pacific Society of Cardiology Consensus Recommendations on the Use of MitraClip for Mitral Regurgitation

et al. 2021

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Transcatheter mitral valve repair with the MitraClip, a catheter-based percutaneous edge-to-edge repair technique to correct mitral regurgitation (MR), has been demonstrated in Western studies to be an effective and safe MR treatment strategy. However, randomised clinical trial data on its use in Asian-Pacific patients is limited. Hence, the Asian Pacific Society of Cardiology convened an expert panel to review the available literature on MitraClip and to develop consensus recommendations to guide clinicians in the region. The panel developed statements on the use of MitraClip for the management of degenerative MR, functional MR, and other less common indications, such as acute MR, dynamic MR, hypertrophic obstructive cardiomyopathy, and MR after failed surgical repair. Each statement was voted on by each panel member and consensus was reached when 80% of experts voted ‘agree’ or ‘neutral’. This consensus-building process resulted in 10 consensus recommendations to guide general cardiologists in the evaluation and management of patients in whom MitraClip treatment is being contemplated.

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“…Recent device iterations (i.e., MitraClip G4) feature separate grasping ability and different arm/gripper width, and facilitate real-time LA-pressure monitoring on the guide catheter. Initial results of a study including 59 patients showed residual MR (grade › 2+) in 3.5%, which appears to be surpassing the results of large trials in terms of MR grade reduction [ 30 ]. In particular for SMR, wider arms might contribute to enhanced leaflet apposition as none of the patients in the SMR arm had SMR grade › 2 at 30 days follow-up.…”

Section: Edge-to-edge Leaflet Coaptationmentioning

confidence: 99%

Transcatheter Repair and Replacement Technologies for Mitral Regurgitation: a European Perspective

Ooms

Mieghem

2021

Curr Cardiol Rep

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Purpose of Review We aimed to picture the contemporary landscape of available catheter-based repair and replacement solutions for mitral regurgitation (MR) in Europe. Recent Findings Edge-to-edge repair remains the dominant technique for transcatheter mitral valve repair especially in the context of secondary mitral regurgitation. Two recent randomized trials reported seemingly contradicting clinical results with transcatheter edge-to-edge repair for patients with heart failure and severe secondary MR. A proportionality framework related to secondary MR was proposed to help explain inconsistencies but requires further research. (In)Direct annuloplasty primarily aims to correct secondary MR; however, the scientific basis seems less robust. One dedicated transcatheter heart valve has the CE mark for mitral valve replacement but requires transapical access. Balloon-expandable transcatheter aortic valve platforms are emerging for transvenous transseptal mitral replacement in the context of mitral annular calcification, a failing surgical mitral bioprosthesis, or annuloplasty. Advanced computed tomography imaging techniques improved pre-procedural planning and introduced the option for modeling and simulation. Summary Development of a toolbox of catheter-based technologies, complementary imaging modalities, and refined patient selection offer novel perspectives to high-risk patients with primary or secondary MR. Clinical trials are required to help formulate evidence-based guidelines for the management of mitral valve disease.

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Transcatheter Edge-to-Edge Mitral Valve Repair With the MitraClip G4 System

Cited by 77 publications

References 11 publications

Complications Following MitraClip Implantation

Complications Following MitraClip Implantation

Asian Pacific Society of Cardiology Consensus Recommendations on the Use of MitraClip for Mitral Regurgitation

Transcatheter Repair and Replacement Technologies for Mitral Regurgitation: a European Perspective

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