Improved mitral valve coaptation and reduced mitral valve annular size after percutaneous mitral valve repair (PMVR) using the MitraClip system

Aims Improved mitral valve leaflet coaptation with consecutive reduction of mitral regurgitation (MR) is a central goal of percutaneous valve repair (PMVR) with the MitraCliprS system. As influences of PMVR on mitral valve geometry have been suggested before, we examined the effect of the procedure on mitral annular size in relation to procedural outcome. Methods and results Geometry of the mitral valve annulus was evaluated in 183 patients undergoing PMVR using echocardiography before and after the procedure and at follow-up. Mitt-al valve annular anterior posterior (ap) diameter decreased from 34.0 +/- 4.3 to 31.3 +/- 4.9 mm (P<0.001), and medio-lateral (ml) diameter from 33.2 +/- 4.8 to 32.4 +/- 4.9 mm (P<0.001). Accordingly, we observed an increase in MV leaflet coaptation after PMVR. The reduction of mitral valve ap diameter showed a significant inverse correlation with residual MR. Importantly, the reduction of mitral valve ap diameter persisted at follow-up (31.3 +/- 4.9 mm post PMVR, 28.4 +/- 5.3 mm at follow-up). Conclusion This study demonstrates mechanical approximation of both mitral valve annulus edges with improved mitt-al valve annular coaptation by PMVR using the MitraClipr system, which correlates with residual MR in patients with MR.