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https://doi.org/10.15836/ccar2025.119

Transcatheter edge-to-edge repair in mitral and tricuspid regurgitation: a review of results at University Hospital Centre Zagreb

Karla Schwarz ; University of Zagreb, School of Medicine, Zagreb, Croatia
Nino Petroci orcid id orcid.org/0009-0000-4371-4669 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Luka Perčin orcid id orcid.org/0000-0003-0497-6871 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Andrea Studen orcid id orcid.org/0000-0003-1835-3894 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Blanka Glavaš-Konja orcid id orcid.org/0000-0003-1134-4856 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Sandra Jakšić Jurinjak orcid id orcid.org/0000-0002-7349-6137 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Joško Bulum orcid id orcid.org/0000-0002-1482-6503 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Boško Skorić orcid id orcid.org/0000-0001-5979-2346 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Zvonimir Ostojić orcid id orcid.org/0000-0003-1762-9270 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Vlatka Rešković-Lukšić orcid id orcid.org/0000-0002-4721-3236 ; University of Zagreb, School of Medicine, Zagreb, Croatia
Jadranka Šeparović-Hanževački orcid id orcid.org/0000-0002-3437-6407 ; University of Zagreb, School of Medicine, Zagreb, Croatia


Puni tekst: engleski pdf 610 Kb

str. 119-120

preuzimanja: 170

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Sažetak

Ključne riječi

mitral valve insufficiency; tricuspid valve insufficiency; transcatheter edge-to-edge repair

Hrčak ID:

330625

URI

https://hrcak.srce.hr/330625

Datum izdavanja:

5.5.2025.

Posjeta: 454 *



Introduction: Transcatheter edge-to-edge repair (TEER) is a minimally invasive procedure aimed at treating patients with mitral or tricuspid regurgitation who are at high surgical risk. This technique allows access to the valves without open-heart surgery. A catheter, inserted through an intravenous line, guides a clip device (e.g. MitraClip or TriClip) to the affected valve, where it grasps the leaflets and pulls them together to reduce the regurgitation orifice (1,2).

Methods and Results: We analyzed 34 patients with mitral regurgitation treated with MitraClip. Among them, 14.7% (n=5) required two clips. The average follow-up was 18 ± 16 months, with a mortality rate of 14.7% (n=5), occurring on average 17 months post-procedure. Hospitalization for heart failure was necessary in 8.8% (n=3) of patients after a successful procedure, and re-intervention was required in 5.9% (n=2). We observed a significant reduction in NT-proBNP levels, declining from an average of 7516 pg/mL before the intervention to 1595 pg/mL afterward. The average daily dose of furosemide was significantly reduced from 150 mg to 88 mg. Importantly, NYHA functional status improved, reflecting better symptom management and enhanced functional capacity (Figure 1). Concerning tricuspid regurgitation, 12 patients underwent treatment with TriClip, with two clips required in 66.7% (n=8) of cases. The average follow-up period was 6 ± 4 months, with no mortality. Hospitalization for heart failure occurred in 25% (n=3). Post-procedure follow-up indicated notable improvement in NYHA status (Figure 2).

FIGURE 1 New York Heart Association (NYHA) status before and after MitraClip (MC) procedure.
CC202520_5-6_119-20-f1
FIGURE 2 New York Heart Association (NYHA) status before and after TriClip (TC) procedure.
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Conclusion: Both MitraClip and TriClip procedures significantly enhance the functional status of patients with mitral and tricuspid regurgitation. MitraClip treatment resulted in reductions in NT-proBNP levels and diuretic requirements. While some patients required re-intervention or hospitalization, overall mortality remained consistent with expectations. These findings demonstrate the effectiveness of TEER in improving quality of life and managing heart failure symptoms.

LITERATURE

1 

Silaschi M, Cattelaens F, Alirezaei H, Vogelhuber J, Sommer S, Sugiura A, et al. Transcatheter Edge-to-Edge Mitral Valve Repair versus Minimally Invasive Mitral Valve Surgery: An Observational Study. J Clin Med. 2024 February 28;13(5):1372. https://doi.org/10.3390/jcm13051372 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/38592259

2 

Overtchouk P, Piazza N, Granada J, Soliman O, Prendergast B, Modine T. Advances in transcatheter mitral and tricuspid therapies. BMC Cardiovasc Disord. 2020 January 7;20(1):1. https://doi.org/10.1186/s12872-019-01312-3 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/31910809


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