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Efetividade do MitraClip no tratamento da insuficiência mitral em pacientes idosos
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Palavras-chave

Insuficiência mitral
Regurgitação mitral
Idosos
Reparo transcateter da valva mitral
MitraClip

Como Citar

Efetividade do MitraClip no tratamento da insuficiência mitral em pacientes idosos. (2025). Revista Eletrônica Acervo Saúde, 25, e19588. https://doi.org/10.25248/reas.e19588.2025

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Resumo

Objetivo: Avaliar a efetividade do reparo transcateter com o dispositivo MitraClip no tratamento da insuficiência mitral em pacientes idosos. Métodos: Trata-se de uma revisão integrativa de literatura realizada por meio da busca nas bases de dados PubMed e Cochrane Library. Após aplicação dos critérios de elegibilidade, 34 artigos foram selecionados. Resultados: O uso do MitraClip está associado ao aumento na expectativa e na qualidade de vida dos pacientes com regurgitação mitral. Ressalta-se que essa tecnologia é uma opção financeira viável em comparação ao custo da terapia medicamentosa, além de ser considerada a melhor alternativa em pacientes nos quais o reparo com a cirurgia aberta da valva mitral é impossibilitado. O MitraClip demonstrou diminuição da regurgitação mitral residual, poucas complicações e baixa mortalidade pelo procedimento. Considerações finais: Considera-se que o MitraClip é uma estratégia terapêutica eficaz para pacientes idosos, tendo em vista que a maioria dos pacientes apresenta alto risco para a cirurgia aberta da valva mitral. Deve-se, entretanto, prescrever seu uso apenas a pacientes não elegíveis à cirurgia aberta. Assim, o uso do MitraClip deve apresentar indicação clínica criteriosa.

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Referências

AILAWADI G, et al. One-Year Outcomes After MitraClip for Functional Mitral Regurgitation. Circulation, 2019; 139(1): 37–47.

ALLAHAM H, et al. Outcomes of percutaneous mitral valve repair in systolic versus diastolic congestive heart failure. Cardiovascular revascularization medicine: including molecular interventions, 2021; 28: 39–41.

ARNOLD SV, et al. Health Status Changes and Outcomes in Patients With Heart Failure and Mitral Regurgitation: COAPT Trial. Journal of the American College of Cardiology, 2020; 75(17): 2099–2106.

BARON SJ, et al. Cost-Effectiveness of Transcatheter Mitral Valve Repair Versus Medical Therapy in Patients With Heart Failure and Secondary Mitral Regurgitation. Circulation, 2019; 140(23): 1881–1891.

BENITO‐GONZÁLEZ T, et al. MitraClip improves cardiopulmonary exercise test in patients with systolic heart failure and functional mitral regurgitation. ESC heart failure, 2019: 6(4): 867–873.

BUZZATTI N, et al. Transcatheter or surgical repair for degenerative mitral regurgitation in elderly patients: A propensity-weighted analysis. The Journal of Thoracic and Cardiovascular Surgery, 2019; 158(1): 86-941.

CHAKRAVARTY T, et al. Transcatheter Edge-to-Edge Mitral Valve Repair With the MitraClip G4 System. Cardiovascular interventions, 2020; 13(20): 2402–2414.

CHAUDHARI SS e MANI BC. Mitral Valve Insufficiency. Treasure Island: Statpearls Publishing, 2023; 23.

CHEN W, et al. Usefulness of Age (≥85 Years) and Residual Mitral Regurgitation (>1+/4+) for the Prediction of Adverse Outcomes in Patients Receiving the MitraClip. The American journal of cardiology, 2019; 124(9): 1449–1453.

CHRISTIDI A, et al. Two year outcome in nonagenarians undergoing percutaneous mitral valve repair. ESC Heart Fail, 2021; 8(1): 577-585.

CIMINO S, et al. Mid-term repair durability after MitraClip implantation in patients with functional mitral regurgitation. Journal of cardiovascular medicine (Hagerstown, Md.), 2019; 20(10): 701–708.

DOLDI PM, et al. Percutaneous edge‐to‐edge repair of severe mitral regurgitation using the MitraClip XTR versus NTR system. Clinical Cardiology, 2021; 44(5): 708–714.

DOUEDI S e DOUEDI H. Mitral Regurgitation. Treasure Island: StatPearls Publishing, 2024; 49.

GARCIA S, et al. Percutaneous Mitral Valve Repair With MitraClip in Inoperable Patients With Severe Mitral Regurgitation Complicated by Cardiogenic Shock. Clinical cardiology, 2021; 44(5): 708–714.

GIORDANO A, et al. Characteristics and outcomes of MitraClip in octogenarians: Evidence from 1853 patients in the GIOTTO registry. International journal of cardiology, 2021; 342: 65–71.

KAR S, et al. Five-year outcomes of transcatheter reduction of significant mitral regurgitation in high-surgical-risk patients. Heart (British Cardiac Society), 2019; 105(21): 1622–1628.

KESSLER M, et al. Predictors of rehospitalization after percutaneous edge-to-edge mitral valve repair by MitraClip implantation. European journal of heart failure, 2019; 21(2): 182–192.

KOSMIDOU I, et al. Transcatheter Mitral Valve Repair in Patients With and Without Cardiac Resynchronization Therapy. Circulation Heart failure, 2020; 13(11): 7293.

LEDWOCH J, et al. Impact of transcatheter mitral valve repair using MitraClip on right ventricular remodeling. The international journal of cardiovascular imaging, 2020; 36(5): 811–819.

LEE CW, et al. Feasibility of the transcatheter mitral valve repair for patients with severe mitral regurgitation and endangered heart failure. Journal of the Formosan Medical Association, 2021; 120: 452–459.

MACK MJ, et al. 3-Year Outcomes of Transcatheter Mitral Valve Repair in Patients With Heart Failure. Journal of the American College of Cardiology, 2021; 77(8): 1029–1040.

MALIK U, et al. Baseline Functional Capacity and Transcatheter Mitral Valve Repair in Heart Failure With Secondary Mitral Regurgitation. JACC. Cardiovascular interventions, 2020; 13(20): 2331–2341.

MKALALUH S, et al. Failed MitraClip therapy: surgical revision in high-risk patients. Journal of cardiothoracic surgery, 2019; 14(1): 75.

MUNAFÒ AR, et al. 2-year outcomes of MitraClip as a bridge to heart transplantation: The international MitraBridge registry. International journal of cardiology, 2023; 390: 131139.

OSTOVAR R, et al. MitraClip: a word of caution regarding an all too liberal indication and delayed referral to surgery in case of failure. European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery, 2021; 59(4): 887–893.

ÖZTÜRK C, et al. Left atrial global function in chronic heart failure patients with functional mitral regurgitation after MitraClip. Catheterization and cardiovascular interventions: official journal of the Society for Cardiac Angiography & Interventions, 2020; 96(3): 678–684.

ÖZTÜRK C, et al. Single-center five-year outcomes after interventional edge-to-edge repair of the mitral valve. Cardiology journal, 2021; 28(2): 215–222.

PAULUS MG, et al. Predictors of functional improvement in the short term after MitraClip implantation in patients with secondary mitral regurgitation. PloS one, 2020; 15(5): 232817.

RADER F, et al. Mitral Valve Surgery After Failed MitraClip: A Single-Center Experience. Journal of invasive cardiology, 2021; 33(4): 236–243.

REICHART D, et al. The impact of residual mitral regurgitation after MitraClip therapy in functional mitral regurgitation. European journal of heart failure, 2020; 22(10): 1840–1848.

RUBBIO AP, et al. Transcatheter edge-to-edge mitral valve repair in atrial functional mitral regurgitation: insights from the multi-center MITRA-TUNE registry. International journal of cardiology, 2022; 349: 39–45.

SANCHIS L, et al. Safety and outcomes of MitraClip implantation in functional mitral regurgitation according to degree of left ventricular dysfunction. Revista espanola de cardiologia (English ed.), 2019; 73(7): 530–535.

SCHNITZLER K, et al. Complications Following MitraClip Implantation. Current cardiology reports, 2021; 23(9): 131.

SHERIF MA, et al. MitraClip step by step; how to simplify the procedure. Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2017; 25(2): 125–130.

SONG C, et al. Age-Related Outcomes After Transcatheter Mitral Valve Repair in Patients With Heart Failure. JACC. Cardiovascular interventions, 2022; 15(4): 397–407.

TANAKA T, et al. Transcatheter Edge-to-Edge Repair for Atrial Secondary Mitral Regurgitation. JACC. Cardiovascular interventions, 2022; 15(17): 1731–1740.

ULLAH W, et al. Outcomes of open mitral valve replacement versus Transcatheter mitral valve repair; insight from the National Inpatient Sample Database. International journal of cardiology. Heart & vasculature, 2020; 28: 100540.

VILLABLANCA PA, et al. Sex-Based Differences in Outcomes With Percutaneous Transcatheter Repair of Mitral Regurgitation With the MitraClip System: Transcatheter Valve Therapy Registry From 2011 to 2017. Circulation. Cardiovascular interventions, 2021; 14(11): 9374.