Effect of transcatheter mitral valve edge-to-edge repair using a domestic NovoClasp system for primary moderate-to-severe mitral regurgitation
10.12007/j.issn.0258-4646.2025.02.006
- VernacularTitle:应用国产NovoClasp系统的经导管二尖瓣缘对缘修复术治疗原发性中重度二尖瓣反流的疗效分析
- Author:
Shuo WANG
1
;
Yinge ZHAN
;
Qinghou ZHENG
;
Gang LIU
;
Le WANG
;
Liu LI
Author Information
1. 石家庄市人民医院心内科,石家庄 050031
- Publication Type:Journal Article
- Keywords:
transcatheter mitral valve edge-to-edge repair;
primary moderate-to-severe mitral regurgitation;
NovoClasp system
- From:
Journal of China Medical University
2025;54(2):127-132
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of transcatheter mitral valve edge-to-edge repair using the domestic NovoClasp system in patients with primary moderate-to-severe mitral regurgitation(MR).Methods A retrospective analysis was conducted on 19 patients with primary MR who underwent transcatheter mitral valve edge-to-edge repair using the domestic NovoClasp system at the Cardiac Center,The First Hospital of Hebei Medical University,and completed a 6-month follow-up.All patients underwent a complete preoperative examination,and the safety and efficiency of surgery were evaluated.The safety indicators included immediate success rate of mitral valve clip,clip displacement,mitral stenosis,heart block,acute heart failure,stroke,access vessel rupture,cardiac tamponade,postoperative MR ≥2+,major bleeding,and death.The efficiency indicators included N-terminal pro-B-type natriuretic peptide(NT-proBNP),soluble growth stimulation expressed gene 2(sST2),left ventricular ejection fraction,left ventricular end diastolic diameter,degree of MR,mean mitral transvalvular pressure gradient,mitral valve opening area,and left atrial anteroposterior diameter at various time points(before surgery and at 7 days,3 months,and 6 months after surgery).Results Safety indicators after surgery showed that the immediate success rate of valve implantation was 100％,including in one patient who received two mitral valve clamps and one who suffered from acute stroke(acute cerebral infarction in the right parietal lobe and left parietal-occipital lobe)after surgery.There were no cases of clamps displace-ment,mitral stenosis,heart block,acute heart failure,access vessel rupture,cardiac tamponade,postoperative MR ≥2+,major bleeding,or death.The effectiveness indicators after surgery showed that the degree of MR significantly improved 7 days after surgery compared with that before surgery(Z=5.466,P＜0.001).Clinical symptoms improved significantly after surgery,with proportion of NYHA Ⅰ-Ⅱ(9 cases,47.4％)significantly higher than that before surgery(1 case,5.3％),and 17 patients(89.5％)of NYHA Ⅰ-Ⅱ achieved good thera-peutic effect as assessed 6 months after surgery.The level of NT-proBNP decreased significantly 7 days after surgery compared with that before surgery(P=0.001);it then gradually decreased during follow-ups.sST2 significantly decreased 3 months after surgery compared with that before surgery(P=0.001),with a gradually decreasing trend thereafter.The left ventricular end-diastolic diameter showed a sig-nificant difference before and 6 months after surgery(P=0.006).The average mitral valve transvalvular pressure gradient was significantly different before and 7 days after surgery(P=0.001),and there was little change within 6 months after surgery.The mitral valve opening area showed a significant difference before and 7 days after surgery(P=0.001),with little change within 6 months after surgery.There were no significant differences in the left ventricular ejection fraction and left atrial anteroposterior diameter before and within 6 months after surgery.Conclusion The transcatheter mitral valve edge-to-edge repair using the domestic NovoClasp system is safe and effective for the treatment of primary moderate-to-severe MR.
