Annual results of percutaneous mitral valve repair using edge-to-edge mitral valve flap coaptation device in patients on the waiting list for heart transplantation

Objective. To analyze the annual results after percutaneous mitral valve repair using edge-to-edge mitral valve coaptation device in patients from the waiting list for heart transplantation. Material and methods. In July 2023, 4 patients underwent percutaneous mitral valve repair with edge-to-edge mitral valve coaptation device for severe mitral regurgitation. Open surgery was refused due to high risk and complicated cardiac diseases (reduced ejection fraction, left ventricular aneurysm, severely decreased left ventricular contractility, pulmonary hypertension, previous cardiac surgeries), and transcatheter intervention was preferred. All patients underwent echocardiography before the intervention, at discharge and one year after correction of mitral regurgitation. Drug therapy, heart failure and adverse cardiovascular events were assessed. Results. All patients were followed-up by a cardiologist and took the prescribed therapy. No significant adverse cardiovascular events were registered throughout the follow-up period. All patients took therapy including diuretics, β-blockers, ACE inhibitors, angiotensin II receptor antagonists, and statins. In long-term follow-up, all patients showed decrease in ejection fraction. In 75% of cases, LV EDV/ESV and pulmonary artery pressure increased compared to in-hospital data. In 3 (75%) patients, mitral insufficiency returned to baseline values after a year. Conclusion. Undoubtedly, percutaneous edge-to-edge mitral valve repair is a fairly promising procedure and provides a chance for favorable outcomes in high-risk patients. This approach can also justify percutaneous intervention as a «bridge» to heart transplantation. However, contradictory data of various studies necessitate further research and accumulation of experience. Therefore, larger samples of patients and analysis of long-term postoperative results will allow us to obtain new knowledge about dynamics of clinical status in patients with CHF and MR, cardiac remodeling and selection criteria for such interventions.