Novel arm-width-expandable transcatheter edge-to-edge repair system: Preclinical experiment and first-in-human study

BackgroundThe ValveClasp system is a novel transcatheter edge-to-edge repair (TEER) device with an arm-width-expandable clip that allows treatment of patients with only one clip more frequently. ObjectivesThis study aimed to evaluate the feasibility and safety of a novel TEER device in porcine models and patients. MethodsFourteen young adult pigs were enrolled. A clip with an expanded arm was implanted under epicardial echocardiography and fluoroscopy guidance. Five patients with at least moderate-to-severe mitral regurgitation underwent TEER using the ValveClasp system to test the safety and effectiveness of the device. ResultsThe device success rate was 100% (14/14) in the animal experiments, and all clips were deployed at the A2P2 segments, forming a double-orifice mitral valve. Gross observations on day 180 showed a wide and continuous tissue bridge between the leaflets. The acute procedural success rate was 100% (5/5). Only one clip was required in all patients, and all achieved effective postoperative endpoints (grade & LE;2+). During 30-day follow-up, no adverse events occurred. All patients' vena Contracta width (from 8.04 0.71 mm to 3.84 & PLUSMN; 1.18 mm, p = 0.012), mitral regurgitation area (from 12.75 & PLUSMN; 3.13 cm(2) to 3.50 & PLUSMN; 1.66 cm(2), p = 0.008), and left ventricular end diastolic diameter (from 52.00 & PLUSMN; 2.92 mm to 46.00 & PLUSMN; 3.08 mm, p = 0.040) were considerably decreased, without obvious mitral stenosis. ConclusionsThe novel arm-width-expandable ValveClasp device is safe for TEER for treating severe mitral regurgitation.