Percutaneous mitral valve (MV) clipping for mitral regurgitation (MR) revolutionized MV repair; however, valve anatomies and pathologies vary. Often multiple clips are required, and predicting this pre-procedurally would be useful. We evaluated pre-procedural predictors for multiple clips. We retrospectively analyzed 127 severe MR patients treated by mitral clipping between January 2011 and August 2018. Patients were grouped according to the use of a single (group I) or multiple clips (group II) and pre-procedure echocardiographs compared. No demographic differences existed except group II had more males (68.1%) than group I (48.3%). Mean left atrial diameter was larger in group II, 51 ± 9 mm, than group I, 48 ± 5 mm, p = 0.026. Mean mitral annular diameter differed: 34 ± 4mm (group II) versus 33 ± 3 mm (group I), p = 0.017. The vena contracta was broader in group II than group I (6.6 ± 1 mm vs. 6 ± 0.9 mm, p = 0.001). Severe mitral annular calcification occurred more in group I (36.2%) than group II (10.1%), p = 0.0001. On multivariate analysis, vena contracta width correlated positively with multiple clips (B 0.125, p = 0.013), but severe annular calcification correlated inversely (B − 0.35, p = 0.002). Vena contracta width and severe annular calcification are factors to consider when planning MV clipping.

中文翻译：

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经皮边缘到边缘二尖瓣修复中多个夹子的术前预测因子

经皮二尖瓣 (MV) 夹闭治疗二尖瓣关闭不全 (MR) 彻底改变了 MV 修复；然而，瓣膜的解剖结构和病理各不相同。通常需要多个剪辑，并且在程序前进行预测会很有用。我们评估了多个剪辑的程序前预测器。我们回顾性分析了 2011 年 1 月至 2018 年 8 月期间接受二尖瓣夹闭术治疗的 127 名重度 MR 患者。 根据使用单个（组 I）或多个夹子（组 II）和术前超声心动图对患者进行分组。除了第 II 组的男性 (68.1%) 比第 I 组 (48.3%) 多之外，不存在人口统计学差异。组 II 的平均左心房直径大于 51 ± 9 mm，大于组 I 的 48 ± 5 mm，p = 0.026。平均二尖瓣环直径不同：34 ± 4 毫米（II 组）与 33 ± 3 毫米（I 组），p = 0.017。组 II 的收缩静脉比组 I 宽（6.6 ± 1 mm 对 6 ± 0.9 mm，p = 0.001）。严重二尖瓣环钙化发生在 I 组 (36.2%) 比组 II (10.1%) 多，p = 0.0001。在多变量分析中，静脉收缩宽度与多个夹子呈正相关（B 0.125，p = 0.013），但严重的环状钙化呈负相关（B - 0.35，p = 0.002）。静脉收缩宽度和严重的环状钙化是计划 MV 夹闭时要考虑的因素。