Transcatheter management of residual mitral regurgitation after transcatheter edge-to-edge repair: a systematic review.

IF 3.1 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Intervention and Therapeutics Pub Date : 2025-01-21 DOI:10.1007/s12928-025-01091-z

Massimo Baudo, Besart Cuko, Julien Ternacle, Serge Sicouri, Olivier Busuttil, Paolo Denti, Cosmo Godino, Carlo De Vincentiis, Basel Ramlawi, Lionel Leroux, Thomas Modine, Altin Palloshi, Francesco Maisano

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Abstract

Background: Treatment of residual mitral regurgitation (MR) with different percutaneous devices after transcatheter edge-to-edge repair (TEER) has been reported as an alternative option to reclipping or surgery. This review aims at describing the different transcatheter strategies available and their results when managing residual MR after TEER.

Methods: A literature search was undertaken across Pubmed, ScienceDirect, SciELO, DOAJ, and Cochrane library databases, to identify article reporting patients with post-TEER residual MR managed by a transcatheter approach that did not involve only the implantation of new clips.

Results: From 439 deduplicated studies, 24 articles ultimately met the inclusion criteria. Fifteen described an occluder device implantation, 12 with an Amplatzer and 3 with a Cardioform. The most feared complications were hemolysis and device embolization. Three cases of transcatheter annuloplasty were reported in patients with residual functional MR. An electrosurgical detachment of the TEER device from the anterior mitral leaflet (ELASTA-Clip) before mitral valve replacement was reported in 6 articles.

Conclusions: Transcatheter procedures addressing residual MR after TEER in carefully selected patients are feasible in experienced centers. Outcomes are promising despite some technical issues. Percutaneous strategies and related complications should be anticipated using multimodality imaging.

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经导管边缘到边缘修复后二尖瓣残余返流的处理：系统回顾。

背景：经导管边缘到边缘修复（TEER）后使用不同的经皮装置治疗残余二尖瓣返流（MR）已被报道为修复或手术的替代选择。这篇综述的目的是描述不同的经导管策略和他们的结果，当处理TEER后残余MR。方法：在Pubmed、ScienceDirect、SciELO、DOAJ和Cochrane图书馆数据库中进行文献检索，以确定通过经导管入路处理teer后残余MR患者的文章，该方法不涉及仅植入新夹。结果：在439篇去重复研究中，24篇文章最终符合纳入标准。15例描述了闭塞装置植入，12例描述了Amplatzer， 3例描述了Cardioform。最可怕的并发症是溶血和器械栓塞。本文报道了3例经导管环成形术治疗功能性残余mr的病例。在二尖瓣置换术前，电手术将TEER装置从前二尖瓣小叶（ELASTA-Clip）分离。结论：在经验丰富的中心，对精心挑选的患者进行经导管治疗TEER后残余MR是可行的。尽管存在一些技术问题，但结果是有希望的。经皮策略和相关并发症应通过多模态成像预测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Intervention and Therapeutics CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.30

自引率

12.50%

发文量

期刊介绍： Cardiovascular Intervention and Therapeutics (CVIT) is an international journal covering the field of cardiovascular disease and includes cardiac (coronary and noncoronary) and peripheral interventions and therapeutics. Articles are subject to peer review and complete editorial evaluation prior to any decision regarding acceptability. CVIT is an official journal of The Japanese Association of Cardiovascular Intervention and Therapeutics.