Efficacy of MitraClip Therapy in Heart Failure Patients with Mitral Insufficiency: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 JIANGZhi-zhi ,  LIUZeng-zhang , CHENGXiao-cheng

Department of Cardiovascular Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 401320, China;

Corresponding author：

LIUZeng-zhang, Email: liuzengzhang666@163.com

Keywords：

MitraClip; Mitral valve insufficiency; Heart failure; Meta-analysis

DOI：

10.7507/1672-2531.20160064

Video：

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Objective To systematically review the efficacy of MitraClip therapy in heart failure patients with mitral insufficiency. Methods Databases including PubMed, The Cochrane Library (Issue 11, 2014), EMbase, CBM, CNKI, VIP and WanFang Data were searched from October 2005 to October 2015 to collect before-after controlled studies about the efficacy of MitraClip therapy in heart failure patients with mitral insufficiency. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 9 studies involving 782 patients were included. The results of meta-analysis showed that, compared with their conditions before treatment, patients after the MitraClip implantation had a declined NYHA class Ⅲ-Ⅳ ratio (RD=0.72, 95%CI 0.60 to 0.85, P<0.000 01), increased left ventricular ejection fraction (LVEF) (MD=-2.97，95%CI -5.06 to -0.89，P<0.005) and improved performance in 6 min walk-test (6-MWT) (MD=-88.73, 95%CI -157.16 to -20.31, P=0.01). Conclusion MitraClip therapy can, to a certain extent, improve the cardiac function of patients with heart failure and mitral insufficiency. However, further studies are needed to confirm its effects on improving the long-term survival of patients.

Citation： JIANGZhi-zhi, LIUZeng-zhang, CHENGXiao-cheng. Efficacy of MitraClip Therapy in Heart Failure Patients with Mitral Insufficiency: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(4): 409-414. doi: 10.7507/1672-2531.20160064 Copy

1.	Triantafyllis AS, Kortlandt F, Bakker AL, et al. Long-term survival and preprocedural predictors of mortality in high surgical risk patients undergoing percutaneous mitral valve repair. Catheter Cardiovasc Interv, 2016, 87(3):467-475.
2.	Bhattacharya S, He Z. Mechanics of mitral valve edge-to-edge-repair and MitraClip procedure. J Long Term Eff Med Implants, 2015, 25(1-2):135-145.
3.	Wöhrle J, Karakas M, Trepte U, et al. Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation. PLoS One, 2015, 10(9):e0137464.
4.	Cacela D, Fiarresga A, Branco L, et al. Percutaneous treatment of mitral valve regurgitation:Initial experience with the MitraClip device. Rev Port Cardiol, 2015, 34(9):515-524.
5.	Carrasco-Chinchilla F, Arzamendi D, Romero M, et al. Initial Experience of Percutaneous Treatment of Mitral Regurgitation with MitraClip^® Therapy in Spain. Rev Esp Cardiol (Engl Ed), 2014, 67(12):1007-1012.
6.	Franzen O, van der Heyden J, Baldus S, et al. MitraClip^® therapy in patients with end-stage systolic heart failure. Eur J Heart Fail, 2011, 13(5):569-576.
7.	Koifman E, Fefer P, Hay I, et al. MitraClip implantation for high risk Patients with severe mitral regurgitation:the Sheba experience. Isr Med Assoc J, 2014, 16(2):91-95.
8.	Lim DS, Reynolds MR, Feldman T, et al. Improved functional status and quality of life in prohibitive surgical risk patients with degenerative mitral regurgitation after transcatheter mitral valve repair. J Am Coll Cardiol, 2014, 64(2):182-192.
9.	Maisano F, Franzen O, Baldus S, et al. Percutaneous mitral valve interventions in the real world:early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol, 2013, 62(12):1052-1061.
10.	Neuss M, Schau T, Schoepp M, et al. Patient selection criteria and midterm clinical outcome for MitraClip therapy in patients with severe mitral regurgitation and severe congestive heart failure. Eur J Heart Fail, 2013, 15(7):786-795.
11.	Perl L, Vaturi M, Assali A, et al. Preliminary experience using the transcatheter mitral Valve leaflet repair Procedure. Isr Med Assoc J, 2013, 15(10):608-612.
12.	Pleger ST, Schulz-Schönhagen M, Geis N, et al. One year clinical efficacy and reverse cardiac remodelling in patients with severe mitral regurgitation and reduced ejection fraction after MitraClip implantation. Eur J Heart Fail, 2013, 15(8):919-927.
13.	奥洛克(美国), 著. 赫斯特心脏病学手册. 王建昌, 王丛妙, 译. 第12版. 北京:人民军医出版社, 2014:437-441.
14.	Adamo M, Barbanti M, Curello S, et al. Effectiveness of MitraClip therapy in patients with refractory heart failure. J Interv Cardiol, 2015, 28(1):61-68.
15.	Feldman T, Foster E, Glower DD, et al. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med, 2011, 364(15):1395-1406.
16.	Whitlow PL, Feldman T, Pedersen WR, et al. Acute and 12-month results with catheter-based mitral valve leaflet repair:the EVEREST Ⅱ (Endovascular Valve Edge-to-Edge Repair) High Risk Study. J Am Coll Cardiol, 2012, 59(2):130-139.
17.	Garatti A, Castelvecchio S, Bandera F, et al. Mitraclip procedure as a bridge therapy in a patient with heart failure listed for heart transplantation. Ann Thorac Surg, 2015, 99(5):1796-1799.
18.	Schueler R, Öztürk C, Wedekind JA, et al. Persistence of iatrogenic atrial septal defect after interventional mitral valve repair with the MitraClip system:a note of caution. JACC Cardiovasc Interv, 2015, 8(3):450-459.
19.	Perl L, Assali A, Vaknin-Assa H, et al. Re-implantation of a mitraclip device in a patient with recurrent mitral regurgitation. Harefuah, 2015, 154(7):423-425.
20.	Schau T, Isotani A, Neuss M, et al. Long-term survival after MitraClip^® therapy in patients with severe mitral regurgitation and severe congestive heart failure A comparison among survivals predicted by heart failure models. J Cardiol, 2016, 67(3):287-294.
21.	Vakil K, Roukoz H, Sarraf M, et al. Safety and efficacy of the MitraClip^® system for severe mitral regurgitation:a systematic review. Catheter Cardiovasc Interv, 2014, 84(1):129-136.

1. Triantafyllis AS, Kortlandt F, Bakker AL, et al. Long-term survival and preprocedural predictors of mortality in high surgical risk patients undergoing percutaneous mitral valve repair. Catheter Cardiovasc Interv, 2016, 87(3):467-475.
2. Bhattacharya S, He Z. Mechanics of mitral valve edge-to-edge-repair and MitraClip procedure. J Long Term Eff Med Implants, 2015, 25(1-2):135-145.
3. Wöhrle J, Karakas M, Trepte U, et al. Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation. PLoS One, 2015, 10(9):e0137464.
4. Cacela D, Fiarresga A, Branco L, et al. Percutaneous treatment of mitral valve regurgitation:Initial experience with the MitraClip device. Rev Port Cardiol, 2015, 34(9):515-524.
5. Carrasco-Chinchilla F, Arzamendi D, Romero M, et al. Initial Experience of Percutaneous Treatment of Mitral Regurgitation with MitraClip^® Therapy in Spain. Rev Esp Cardiol (Engl Ed), 2014, 67(12):1007-1012.
6. Franzen O, van der Heyden J, Baldus S, et al. MitraClip^® therapy in patients with end-stage systolic heart failure. Eur J Heart Fail, 2011, 13(5):569-576.
7. Koifman E, Fefer P, Hay I, et al. MitraClip implantation for high risk Patients with severe mitral regurgitation:the Sheba experience. Isr Med Assoc J, 2014, 16(2):91-95.
8. Lim DS, Reynolds MR, Feldman T, et al. Improved functional status and quality of life in prohibitive surgical risk patients with degenerative mitral regurgitation after transcatheter mitral valve repair. J Am Coll Cardiol, 2014, 64(2):182-192.
9. Maisano F, Franzen O, Baldus S, et al. Percutaneous mitral valve interventions in the real world:early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol, 2013, 62(12):1052-1061.
10. Neuss M, Schau T, Schoepp M, et al. Patient selection criteria and midterm clinical outcome for MitraClip therapy in patients with severe mitral regurgitation and severe congestive heart failure. Eur J Heart Fail, 2013, 15(7):786-795.
11. Perl L, Vaturi M, Assali A, et al. Preliminary experience using the transcatheter mitral Valve leaflet repair Procedure. Isr Med Assoc J, 2013, 15(10):608-612.
12. Pleger ST, Schulz-Schönhagen M, Geis N, et al. One year clinical efficacy and reverse cardiac remodelling in patients with severe mitral regurgitation and reduced ejection fraction after MitraClip implantation. Eur J Heart Fail, 2013, 15(8):919-927.
13. 奥洛克(美国), 著. 赫斯特心脏病学手册. 王建昌, 王丛妙, 译. 第12版. 北京:人民军医出版社, 2014:437-441.
14. Adamo M, Barbanti M, Curello S, et al. Effectiveness of MitraClip therapy in patients with refractory heart failure. J Interv Cardiol, 2015, 28(1):61-68.
15. Feldman T, Foster E, Glower DD, et al. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med, 2011, 364(15):1395-1406.
16. Whitlow PL, Feldman T, Pedersen WR, et al. Acute and 12-month results with catheter-based mitral valve leaflet repair:the EVEREST Ⅱ (Endovascular Valve Edge-to-Edge Repair) High Risk Study. J Am Coll Cardiol, 2012, 59(2):130-139.
17. Garatti A, Castelvecchio S, Bandera F, et al. Mitraclip procedure as a bridge therapy in a patient with heart failure listed for heart transplantation. Ann Thorac Surg, 2015, 99(5):1796-1799.
18. Schueler R, Öztürk C, Wedekind JA, et al. Persistence of iatrogenic atrial septal defect after interventional mitral valve repair with the MitraClip system:a note of caution. JACC Cardiovasc Interv, 2015, 8(3):450-459.
19. Perl L, Assali A, Vaknin-Assa H, et al. Re-implantation of a mitraclip device in a patient with recurrent mitral regurgitation. Harefuah, 2015, 154(7):423-425.
20. Schau T, Isotani A, Neuss M, et al. Long-term survival after MitraClip^® therapy in patients with severe mitral regurgitation and severe congestive heart failure A comparison among survivals predicted by heart failure models. J Cardiol, 2016, 67(3):287-294.
21. Vakil K, Roukoz H, Sarraf M, et al. Safety and efficacy of the MitraClip^® system for severe mitral regurgitation:a systematic review. Catheter Cardiovasc Interv, 2014, 84(1):129-136.

Chinese Journal of Evidence-Based Medicine

Efficacy of MitraClip Therapy in Heart Failure Patients with Mitral Insufficiency: A Meta-analysis

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