Abstract
Transcatheter edge-to-edge mitral valve repair is an approach for treating mitral regurgitation, which is an alternative for surgery in patients with a high surgical risk. Although the safety and efficacy of the technique have been demonstrated, it is still associated with potentially life-threatening complications. The aim of this paper is to discuss the nature, management, and prevention of the most important procedural complications associated with this procedure.
Zusammenfassung
Die Transkatheter-Edge-to-Edge-Mitralklappenrekonstruktion ist ein minimal-invasiver Ansatz zur Behandlung der Mitralklappeninsuffizienz als mögliche Alternative zur chirurgischen Sanierung bei Patienten mit einem hohen perioperativen Risiko. Zwar konnten die Sicherheit und Effektivität der Therapie nachgewiesen werden, potenzielle lebensbedrohliche Komplikationen sind jedoch möglich. Ziel der vorliegenden Arbeit ist die Diskussion der Art, des Managements und der Prävention der wichtigsten Komplikationen, die mit diesem Verfahren einhergehen.
Similar content being viewed by others
References
Carabello BA (2008) The current therapy for mitral regurgitation. J Am Coll Cardiol 52:319–326
Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A et al (2012) Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 33:2451–2496
Alfieri O, Maisano F, De Bonis M et al (2001) The double-orifice technique in mitral valve repair: a simple solution for complex problems. J Thorac Cardiovasc Surg 122:674–681
Feldman T, Wasserman HS, Herrmann HC et al (2005) Percutaneous mitral valve repair using the edge-to-edge technique: six-month results of the EVEREST phase I clinical trial. J Am Coll Cardiol 46:2134–2140
Feldman T, Foster E, Glower DD et al (2011) Percutaneous repair or surgery for mitral regurgitation. N Engl J Med 364:1395–1406
Feldman T, Kar S, Rinaldi M et al (2009) Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort. J Am Coll Cardiol 54:686–694
Franzen O, Baldus S, Rudolph V et al (2010) Acute outcomes of MitraClip therapy for mitral regurgitation in high-surgical-risk patients: emphasis on adverse valve morphology and severe left ventricular dysfunction. Eur Heart J 31:1373–1381
Tamburino C, Ussia GP, Maisano F et al (2010) Percutaneous mitral valve repair with the MitraClip system: acute results from a real world setting. Eur Heart J 31:1382–1389
Pleger ST, Mereles D, Schulz-Schonhagen M et al (2011) Acute safety and 30-day outcome after percutaneous edge-to-edge repair of mitral regurgitation in very high-risk patients. Am J Cardiol 108:1478–1482
Franzen O, Heyden J’ van der, Baldus S et al (2011) MitraClip(R) therapy in patients with end-stage systolic heart failure. Eur J Heart Fail 13:569–576
Van den Branden BJ, Swaans MJ, Post MC et al (2012) Percutaneous edge-to-edge mitral valve repair in high-surgical-risk patients: do we hit the target? JACC Cardiovasc Interv 5:105–111
Divchev D, Kische S, Paranskaya L et al (2012) In-hospital outcome of patients with severe mitral valve regurgitation classified as inoperable and treated with the MitraClip(R) device. J Interv Cardiol 25:180–189
Whitlow PL, Feldman T, Pedersen WR et al (2012) Acute and 12-month results with catheter-based mitral valve leaflet repair: the EVEREST II (Endovascular Valve Edge-to-Edge Repair) high risk study. J Am Coll Cardiol 59:130–139
Baldus S, Schillinger W, Franzen O et al (2012) MitraClip therapy in daily clinical practice: initial results from the German transcatheter mitral valve interventions (TRAMI) registry. Eur J Heart Fail 14:1050–1055
Sürder D, Pedrazzini G, Gaemperli O et al (2013) Predictors for efficacy of percutaneous mitral valve repair using the MitraClip system: the results of the MitraSwiss registry. Heart (Epub ahead of print)
Kolluri R, Fowler B, Nandish S (2013) Vascular access complications: diagnosis and management. Curr Treat Options Cardiovasc Med 15:173–187
Swaans MJ, Post MC, Van den Branden BJ et al (2011) A complicated transseptal puncture during Mitraclip procedure: saved by 3D-TEE. Eur J Echocardiogr 12:E45
Earley MJ (2009) How to perform a transseptal puncture. Heart 95:85–92
Van den Branden BJ, Swaans MJ, Post MC et al (2010) Redo mitral valve clipping after partial clip detachment. JACC Cardiovasc Interv 3:251–252
Braun D, Orban M, Michalk F et al (2013) Three-dimensional transoesophageal echocardiography for the assessment of clip attachment to the leaflets in percutaneous edge-to-edge repair of the mitral valve. EuroIntervention (Epub ahead of print)
Herrmann HC, Kar S, Siegel R et al (2009) Effect of percutaneous mitral repair with the MitraClip device on mitral valve area and gradient. EuroIntervention 4:437–442
Orban M, Lesevic H, Massberg S et al (2013) Left ventricular thrombus formation after successful percutaneous edge-to-edge mitral valve repair. Eur Heart J 34:942
Ren JF, Marchlinski FE, Callans DJ (2004) Left atrial thrombus associated with ablation for atrial fibrillation: identification with intracardiac echocardiography. J Am Coll Cardiol 43:1861–1867
Reddy VY, Holmes D, Doshi SK et al (2011) Safety of percutaneous left atrial appendage closure: results from the Watchman Left Atrial Appendage System for Embolic Protection in Patients with AF (PROTECT AF) clinical trial and the Continued Access Registry. Circulation 123:417–424
Kappetein AP, Head SJ, Genereux P et al (2013) Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. J Thorac Cardiovasc Surg 145:6–23
Conflict of interest
On behalf of all authors, the corresponding author states the following: Dr. Swaans and Dr. Van der Heyden are faculty members/proctors for Abbott Vascular. All other authors report that they have no relationships relevant to the contents of this paper.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bakker, A., Swaans, M., van der Heyden, J. et al. Complications during percutaneous edge-to-edge mitral valve repair. Herz 38, 484–489 (2013). https://doi.org/10.1007/s00059-013-3860-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00059-013-3860-9