ArticleInterdisciplinary cardiovascular and thoracic surgery2025
Electrosurgical Laceration and Stabilization of Clip Followed by Transapical Mitral Valve Replacement after Failed Transcatheter Edge-to-Edge Mitral Valve Repair: A Promising Alternative to Surgery.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe study analyses perioperative outcomes in patients who underwent transcatheter electrosurgical laceration and stabilization of the clip (ELASTA-clip), followed by transapical mitral valve replacement or conventional mitral valve surgery (MVS) after failed transcatheter edge-to-edge mitral valve repair.
methodsConsecutive patients who experienced failure of a transcatheter edge-to-edge mitral valve repair and subsequently underwent either the ELASTA-clip procedure followed by transapical mitral valve replacement or conventional open MVS were retrospectively analysed. Perioperative and mid-term outcomes including mortality, stroke, bleeding, pacemaker implantation, and the need for mechanical circulatory support were assessed descriptively.
resultsA total of 5 patients were enrolled in the ELASTA group and 31 in the open surgery group, with median follow-up periods of 2 years [IQR: 1.2-2.1] and 1.4 years [IQR: 0.3-3.7], respectively. Procedural success was achieved in all ELASTA cases (100%) compared to 96% in the open surgery group. No in-hospital deaths occurred in the ELASTA group, whereas the surgical group had a mortality rate of 6.5% (n = 2). During follow-up, adverse events occurred in 20% (n = 1) of ELASTA patients and 54.8% (n = 17) of those who underwent surgery.
conclusionsSurgical intervention in patients with failed edge-to-edge mitral valve repair carries a high risk of complications. The ELASTA-clip technique, combined with transapical mitral valve replacement, offers a minimally invasive and safe alternative to conventional surgery, highlighting the need for further prospective studies with longer-term follow-up.
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