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首页> 外文期刊>Circulation journal >Real-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation – Compromise Between Mitral Regurgitation Reduction and Maintenance of Adequate Opening Area –
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Real-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation – Compromise Between Mitral Regurgitation Reduction and Maintenance of Adequate Opening Area –

机译：MitraClip治疗重度二尖瓣反流的真实经验–减少二尖瓣反流与维持适当的开放区域之间的妥协–

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Background: ?Percutaneous edge-to-edge mitral valve repair with the MitraClip? was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. Herein is reported our experience on MitraClip? for high-risk surgical candidates with severe mitral regurgitation (MR). Methods and Results: ?Patients with severe MR (3 or 4+) and high operative risk were considered for MitraClip? implantation. Device success was defined as placement of 1 or more MitraClips? with reduction of MR to ≤2+. Patients were followed up clinically and with echocardiography at 1 year. A total of 27 patients with severe MR (age, 74±12 years; 17 male; logistic EuroSCORE, 27±12; left ventricular ejection fraction, 40±17%) were treated. Fifty-six percent of MR was degenerative and 44% was functional. Device success was 93% with 14 patients receiving 2 clips. MR severity was reduced from 3.5±0.5 to 1.7±0.8 (P? implantation was not attempted, with resultant transmitral mean gradient of 4.9±1.6mmHg vs. 3.1±1.4mmHg, respectively (P=0.01). Conclusions: ?MitraClip? was shown to be an effective and safe treatment for patients with both functional and degenerative MR. Inability to obtain a greater reduction of MR was the consequence of borderline transmitral gradient requiring a compromise to avoid mitral stenosis, particularly in the functional MR patients.??( Circ J ?2012; 76: 2488–2493)
机译：背景：与传统的手术二尖瓣修复相比，用MitraClip 进行经皮边缘到边缘二尖瓣修复是一种安全可行的选择。本文报道了我们在MitraClip ？上治疗严重二尖瓣关闭不全（MR）的高风险手术患者的经验。方法和结果：？考虑MitraClip ？植入的具有严重MR（3或4+）和高手术风险的患者。设备成功定义为放置1个或多个MitraClips ？，并将MR降低至≤2+。对患者进行临床随访，并于1年进行超声心动图检查。共治疗了27例严重MR（年龄74±12岁;男性17岁;后勤EuroSCORE，27±12;左心室射血分数，40±17％）。 56％的MR变性，44％的功能性MR。装置成功率为93％，其中14例患者接受了2个夹子。 MR严重程度从3.5±0.5降低至1.7±0.8（未进行P？植入），最终的透射平均梯度分别为4.9±1.6mmHg和3.1±1.4mmHg（P = 0.01）。研究表明，MitraClip ？对于功能性和退行性MR患者均是一种有效且安全的治疗方法，无法获得更大的MR降低是交界性梯度梯度的结果，需要妥协避免二尖瓣狭窄（Circ J？2012; 76：2488-2493），尤其是功能性MR患者。

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