■经皮二尖瓣修复术(PMVR)已发展成为无法进行开放手术的合适二尖瓣反流(MR)患者的标准程序。这里,我们分析了手术过程中植入的夹子的数量和位置对MR减少的影响,并分析了功能性和退行性MR(DMR)的子集合。
■我们纳入了410例使用MitraClip®系统进行PMVR的重度MR患者。在PMVR程序开始和结束时通过TEE分析MR和MR的减少。要指定剪辑本地化,我们使用二尖瓣的节段分类将第2段细分为3个子段。
■我们发现,在接受一个以上剪辑的DMR患者中,MR的减少主要增强。与DMR患者相比,仅植入一个夹子导致功能性MR(FMR)患者的MR降低更高。无论植入的夹子数量如何,在退行性MR患者中都没有观察到有关压力梯度的显着差异。在PMVR后6个月,观察到已实现的MR降低的一半等级的恶化,与FMR患者中具有更好稳定性的植入夹的数量无关。与只有一个夹子的患者相比,谁得到了3个夹子。
■在FMR患者中,6个月后,随着植入夹子数量的增加,MR的减少更加稳定,这表明,这个特定的患者群体可能受益于更多数量的剪辑。
UNASSIGNED: Percutaneous mitral valve repair (PMVR) has evolved to be a standard procedure in suitable patients with mitral regurgitation (MR) not accessible for open surgery. Here, we analyzed the influence of the number and positioning of the clips implanted during the procedure on MR reduction analyzing also sub-collectives of functional and degenerative MR (DMR).
UNASSIGNED: We included 410 patients with severe MR undergoing PMVR using the MitraClip® System. MR and reduction of MR were analyzed by TEE at the beginning and at the end of the PMVR procedure. To specify the clip localization, we sub-divided segment 2 into 3 sub-segments using the segmental classification of the mitral valve.
UNASSIGNED: We found an enhanced reduction of MR predominantly in DMR patients who received more than one clip. Implantation of only one clip led to a higher MR reduction in patients with functional MR (FMR) in comparison to patients with DMR. No significant differences concerning pressure gradients could be observed in degenerative MR patients regardless of the number of clips implanted. A deterioration of half a grade of the achieved MR reduction was observed 6 months post-PMVR independent of the number of implanted clips with a better stability in FMR patients, who got 3 clips compared to patients with only one clip.
UNASSIGNED: In patients with FMR, after 6 months the reduction of MR was more stable with an increased number of implanted clips, which suggests that this specific patient collective may benefit from a higher number of clips.