MitraClip better option than open heart surgery, find researchers

The device called MitraClip placed in the heart via a catheter through a blood vessel in the leg was found equally effective as an open heart surgery procedure, but the complications involved were lesser.

Dr Ted Feldman, director of the cardiac catheterization laboratory at NorthShore University HealthSystem in suburban Chicago and his colleagues carried out the study that aimed to find the efficiency and safety of the device.

“Use of the device may be even more helpful for the frail and elderly, who may be discharged to a rehabilitation facility where recovery from open-heart surgery can take several months,” informs Dr Feldman, the lead researcher.

He adds, “One of our earliest patients literally could not walk across a room without stopping to catch her breath. A week after she was treated, she was doing water aerobics.”

The Study Details
The researchers conducted a randomized EVEREST II (Endovascular Valve Edge-to-Edge Repair Study) trial that included 279 patients aged 68 or more, with moderate or severe mitral regurgitation.

The study participants were randomly assigned to two groups. 184 received the MitraClip implant, while 95 underwent surgery.

It was found that the device was successful in treating 72.4 percent of patients compared with 87.8 per cent in the surgery group.

“This is a stunning difference in safety for an acceptable trade-off in efficacy for many patients,” Dr Feldman informs.

Only 9.6 percent of those treated with the MitraClip reported any major side effects at 30 days compared with 57 percent in the surgery group.

The adverse effects included gastrointestinal complication requiring surgery and blood transfusions, while the surgery patients also had deaths, major strokes, re-operation of the mitral valve, and urgent surgery.

The Advantage of the MitraClip
“The EVEREST II safety and effectiveness results support the MitraClip device as a treatment choice, and show that MitraClip patients still have the option for successful mitral valve surgery afterward if needed,” says Dr Donald Glower, professor of surgery from the Cardiovascular and Thoracic Surgery Division, Duke University School of Medicine, Durham and co-investigator of the EVEREST II trial.

“The improvements in symptoms, quality of life and cardiac function shown in the EVEREST II trial suggest the MitraClip procedure may be another valuable treatment option for certain patients with significant MR,” he adds.

Cardio experts also feel that with an alternate option available, there was scope for better treatment of patients with mitral regurgitation.

The study was presented at the American College of Cardiology scientific meeting in Atlanta.