Comparison of effectiveness and survival after the MitraClip or Carillon procedure for severe functional mitral regurgitation: a single-center retrospective analysis.

Stephan Heyl, Aria Nikkhoo, Markus Wieszner, Stephan Fichtlscherer, Florian Seeger, Birgit Assmus, Brigitte Luu, Katrin Hemmann, Claudia Walther, Joerg Honold
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Abstract

Introduction: Current studies suggest improved survival in patients with severe functional mitral regurgitation (FMR) treated successfully with the MitraClip (MC) compared to medical treatment alone, in addition to a significant reduction of FMR severity. Recently, the Carillon system (CS) has also been shown to significantly reduce FMR. However, whether this beneficial effect of CS also translates into a survival benefit comparable to the MC system has not been investigated so far. The aim of the study was to compare the course of FMR grade and mortality after MC or CS in a retrospective, non-randomized, single-center analysis.

Material and methods: A hundred and fifty-four patients with symptomatic FMR 2+ were included in this study (MC: n = 117, CS: n = 37). Baseline characteristics did not differ significantly between groups.

Results and conclusions: Initially, the degree of FMR was reduced in the MC group from 2.9 ±0.3 to 1.7 ±0.7 and from 2.7 ±0.5 to 2.1 ±0.7 in the CS group, p within and between groups < 0.01. Within 6 months, FMR remained reduced in the MC group (1.83 ±0.6) and CS group (2.1 ±0.7). One-year survival was 34.8% in the MC group and 54.8% in the CS group (p = 0.663). Median long-term survival was 1.66 years in the MC group and 3.92 years in the CS group, log rank p = 0.001.

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MitraClip 或 Carillon 手术治疗严重功能性二尖瓣反流后的有效性和存活率比较:单中心回顾性分析。
导言:目前的研究表明,与单纯药物治疗相比,成功使用 MitraClip(MC)治疗的重度功能性二尖瓣反流(FMR)患者的生存率更高,而且 FMR 的严重程度也明显减轻。最近,Carillon 系统(CS)也被证明能显著降低 FMR。然而,CS的这种有益效果是否也能转化为与MC系统相媲美的生存益处,迄今尚未得到研究。本研究旨在通过一项回顾性、非随机、单中心分析,比较 MC 或 CS 术后 FMR 分级和死亡率的变化情况:本研究共纳入 154 名无症状 FMR 2+ 患者(MC:117 人,CS:37 人)。各组间的基线特征无明显差异:最初,MC 组的 FMR 从 2.9 ±0.3 降至 1.7 ±0.7,CS 组的 FMR 从 2.7 ±0.5 降至 2.1 ±0.7,组内和组间的 p 均小于 0.01。在6个月内,MC组(1.83 ±0.6)和CS组(2.1 ±0.7)的FMR仍然下降。MC 组的一年生存率为 34.8%,CS 组为 54.8%(P = 0.663)。MC 组的中位长期生存期为 1.66 年,CS 组为 3.92 年,对数秩 p = 0.001。
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