title: Initial French experience of percutaneous mitral valve repair with the MitraClip: a multicentre national registry.
abstract: BACKGROUND
  Percutaneous mitral valve repair (MVR) using the MitraClip(®) is a new option for severe mitral regurgitation (MR).
  
  
  OBJECTIVE
  To describe initial French experience regarding short-term and mid-term safety and efficacy.
  
  
  METHODS
  A multicentre cohort reported experience of percutaneous MVR using the MitraClip(®) in French centres from December 2010 to September 2012. All patients were judged inoperable or at high surgical risk. Short-term and mid-term safety and efficacy results are presented.
  
  
  RESULTS
  Sixty-two patients (72.7±11.4years; 71.7% men; 81.0% New York Heart Association [NYHA] class III or IV; logistic Euroscore 18.7±13.1%; 93.3% MR≥grade 3; 73.8% secondary MR) underwent percutaneous MVR using the MitraClip(®) under general anaesthesia. Procedural success was 95.2% (83.1% of patients received one clip; 16.9% received two clips). At discharge, 88.2% of implanted patients had a residual MR≤grade 2. Transthoracic echocardiography showed a significant decrease in ejection fraction (39.9±14.8% pre vs. 36.2±14.3% post), end-diastolic diameter (63.8±10.6mm vs. 61.4±12.3mm, respectively) and systolic pulmonary pressure (52.1±13.9mmHg vs. 44.7±10.9mmHg, respectively). The in-hospital mortality rate was 3.2%. The survival rate at 6-month follow-up was estimated at 83.1%, with 90.9% of patients in NYHA class I or II and residual MR≤grade 2 in 80% of cases.
  
  
  CONCLUSIONS
  This initial French experience, despite being in its learning phase, showed promising results in patients considered ineligible for surgery, as observed in more experienced centres. Randomized studies are mandatory to confirm these preliminary data.
authors.affiliation: Hospices Civils de Lyon, Délégation à la Recherche Clinique et à l'Innovation, Cellule Innovation, quai des Célestins, 69000 Lyon, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Armoiry
authors.forename: Eric
authors.initials: E
authors.lastname: Brochet
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefevre
authors.forename: Patrice
authors.initials: P
authors.lastname: Guerin
authors.forename: Nicolas
authors.initials: N
authors.lastname: Dumonteil
authors.forename: Dominique
authors.initials: D
authors.lastname: Himbert
authors.forename: Bertrand
authors.initials: B
authors.lastname: Cormier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Piriou
authors.forename: Mathieu
authors.initials: M
authors.lastname: Gautier
authors.forename: David
authors.initials: D
authors.lastname: Messika-Zeitoun
authors.forename: Mauro
authors.initials: M
authors.lastname: Romano
authors.forename: Gilles
authors.initials: G
authors.lastname: Rioufol
authors.forename: Karine
authors.initials: K
authors.lastname: Warin Fresse
authors.forename: Nicolas
authors.initials: N
authors.lastname: Boudou
authors.forename: Florence
authors.initials: F
authors.lastname: Leclercq
authors.forename: Marc
authors.initials: M
authors.lastname: Bedossa
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Obadia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D005260:Female; D005602:France; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011474:Prosthesis Design; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D013318:Stroke Volume; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome