Mitra Clip: Treatment of Secondary Mitral Regurgitation

Written by John Steuter, MD

The MitraClip device is already approved in the U.S. for use in primary mirtal regurgitation (MR), a condition in which the mitral valve leaflets do not function properly due to a degenerative defect.

Whether the device is useful for secondary MR, in which the valve structure is normal, but the ventricle is enlarged, has still been in question. The prognosis for heart failure patients who develop severe secondary mitral regurgitation is poor with limited treatment options.

COAPT Trial Investigates MitraClip Effectiveness for Secondary MR

COAPT was a randomized, parallel-controlled, open-label multicenter trial evaluating transcatheter mitral valve repair with the MitraClip device in symptomatic heart failure patients with moderate-to-severe or severe secondary MR.

• 614 subjects were randomized at 78 centers in the United States and Canada
• 302 patients were assigned to the device and guideline-directed medical therapy (GDMT) in the device group
• 312 patients were assigned to GDMT alone in the control group

Photo courtesy of thekeyholeheart.com

Photo courtesy of Northwestern Medicine

The Results: Impressive

The primary effectiveness endpoint was the annualized rate of all heart failure hospitalizations through 24 months and the primary safety endpoint was freedom from device-related complications at 12 months.

The annualized rates of heart failure hospitalization were 35.8% per patient-year in the device group versus 67.9% per patient-year in the control group.

All-cause mortality at 24 months with the device was 29.1% compared to 46.1% in the control group.

This procedure adds an important option for high-risk heart failure patients with secondary MR who remain symptomatic despite optimal medical therapy.

Advanced MR Therapy at Bryan Heart

At Bryan Heart we are proud to provide this therapy and many other advanced cardiac treatments for our patients. For questions or to refer a patient, call 402-483-3333.