Changes in mitral valve geometry after percutaneous valve repair with the MitraClip® System

The aim of our study was to assess the anatomical changes of the mitral valve apparatus after percutaneous repair with the MitraClip (R) system. We included consecutive patients who underwent MitraClip (R) implantation in our center. Patients were assessed by 2- and 3-dimensional transesophageal echocardiography, acquired before and immediately after MitraClip (R) implantation. Off-line images analysis was performed to assess mitral annular diameters (antero-posterior and inter-commisural), area and circumference. Mitral tenting distance, area and volume were evaluated for functional mitral regurgitation. Patients had a 2-dimensional transthoracic echocardiography at follow-up (8 months). 38 patients with successful results (residual mitral regurgitation grade <= II) were included. The anteroposterior annulus diameter (ADP) decreased (from 35 +/- 5 to 28 +/- 5 mm, p < 0.001) with smaller decreases in the annular area and circumference and in the inter-commissural diameter. Annular ellipticity improved. The reduction in APD and tenting distance was sustained at follow-up. Successful percutaneous mitral valve repair with the MitraClip (R) system induces a stable change in mitral valve geometry mainly at the ADP, suggesting a significant annuloplasty that contributes to the reduction of mitral regurgitation.