Structural Heart (Mar 2023)

Percutaneous Transcatheter Edge-to-Edge Mitral Valve Repair With MitraClip System in the Era of G4

  • Iria Silva, MD,
  • Pierre Yves Turgeon, MD,
  • Jean-Michel Paradis, MD,
  • Jonathan Beaudoin, MD,
  • Kim O’Connor, MD,
  • Julien Ternacle, MD, PhD,
  • Alberto Alperi, MD,
  • Vassili Panagides, MD,
  • Jules Mesnier, MD,
  • Caroline Gravel, RN,
  • Marie-Annick Clavel, DVM, PhD,
  • François Dagenais, MD,
  • Eric Dumont, MD,
  • Siamak Mohammadi, MD,
  • Philippe Pibarot, DVM, PhD,
  • Mathieu Bernier, MD,
  • Josep Rodés-Cabau, MD,
  • Erwan Salaun, MD, PhD

Journal volume & issue
Vol. 7, no. 2
p. 100114

Abstract

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The use of transcatheter edge-to-edge mitral valve repair (TEER) in symptomatic patients with severe mitral regurgitation (MR) has dramatically increased over the last few years. Current guidelines consider TEER as a reasonable option in symptomatic patients with primary or chronic secondary severe MR with high or prohibitive surgical risk and favorable anatomy. However, several anatomical and morphological mitral features have restricted the use of this mini-invasive technique in its early experience. The latest fourth generation (G4) of the MitraClip system has been recently introduced and includes the possibility of independent leaflet grasping and 4 different sizes. This technical update offers the possibility of selecting and combining multiple devices for complex mitral valve anatomies and challenging procedures, which helps expand the applications of TEER. The present review describes the potential advantages and the help of the MitraClip G4 devices to overcome various anatomic and morphologic issues in challenging cases with complex primary and secondary MR procedures.

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