Percutaneous mitral repair with-mitraclip system, safety and efficacy; initial Egyptian experience

To evaluate the feasibility, efficacy, and safety of the MitraClip system in patients with severe MR. Background: Mitral valve repair for mitral regurgitation (MR) has been performed by the use of a surgically created double orifice. Percutaneous repair based on this surgical approach has been developed by use of the MitraClip device to secure the mitral leaflets. Methods: Five Patients with 3 to 4+ MR were selected in accordance with the American Heart Association/American College of Cardiology guidelines between March 2013 and May 2013 and underwent percutaneous mitral repair with MitraClip system . Patients were followed up for six months after procedure. The primary acute safety endpoint was freedom from major adverse events (MAEs) at 30 days, defined as the composite of death, myocardial infarction, non-elective cardiac surgery for adverse events, renal failure, transfusion of more than 2 units of blood, ventilation for more than 48 h, deep wound infection, septicemia. The primary efficacy endpoint is acute device success defined as clip implant with reduction of MR to equal or less than grade II, based on current guidelines. Results: A total of 5 patients were treated. No patients (0%) had a major adverse event,. Freedom from clip embolization was 100%. Partial clip detachment had not occurred in any patients (0%) patients. Overall, 4 of 5 (80%) patients achieved acute procedural success, and 3 (60%) were discharged with MR of ⩽1+. Conclusions: Our initial results with the MitraClip device in a very small number of patients indicate that percutaneous edge-to edge mitral valve repair is feasible and may be accomplished with favorable short-term safety and efficacy results