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\begin{document}

\title{Severe mitral regurgitation recurrence after successful percutaneous
mitral edge-to-edge repair by Mitraclip: Insights from a
three-dimensional echocardiography study}



\author[1]{Yoan Lavie Badie}%
\author[1]{Fabien Vannier}%
\author[1]{Eve Cariou}%
\author[1]{Pauline Fournier}%
\author[1]{Romain Itier}%
\author[1]{Stéphanie Cazalbou}%
\author[1]{Virginie Blanchard}%
\author[1]{Michel Galinier}%
\author[1]{Didier Carrie}%
\author[1]{Olivier Lairez}%
\author[1]{Frédéric Bouisset}%
\author[1]{Thibault Lhermusier}%
\affil[1]{Hopital de Rangueil}%


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  \date{June 05, 2024}


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\begin{abstract}
Background: The sustainability of the results of mitraclip procedures is
a source of concern. Aims: To investigate risk factors of severe mitral
regurgitation (MR) recurrence after Mitraclip in primary MR. Methods and
results: Eighty-three patients undergoing successful Mitraclip
procedures were retrospectively included. Valve anatomy and Mitraclips
placement were comprehensively analyzed by post-processing 3D
echocardiographic acquisition. The primary composite endpoint was the
recurrence of severe MR. Mean age was 83\selectlanguage{ngerman}±7 years-old, 37 (44\%) were
female. Median follow-up was 381 days (IQR 195-717) and 17 (20\%)
patients reached the primary endpoint. Main causes of recurrence of
severe MR were relapse of a prolapse (64\%) and single leaflet
detachment (23\%). Posterior coaptation line length (HR 1.06 95\%CI
1.01-1.12 p=0.02), poor imaging quality (HR 3.84, 95\%CI1.12-13.19;
p=0.03), and inter-clip distance (HR 1.60, 95\%CI 1.27-2.02;
p\textless{}0.01) were associated with the occurrence of the primary
endpoint. Conclusions: Recurrence of severe MR after a MitraClip
procedure for primary MR is common and results from a complex interplay
between anatomical (tissue excess) and procedural criteria (quality of
ultrasound guidance and MitraClips spacing).%
\end{abstract}\selectlanguage{ngerman}%



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