Efficacy Of Mitraclip Therapy In Heart Failure Patients With Mitral Insufficiency: A Meta-analysis

Objective To systematically review the efficacy of Mitra Clip therapy in heart failure patients with mitral insufficiency.Methods Databases including Pub Med,VIP,The Cochrane Library,and Wan Fang Data,EMbase,CBM,and CNKIwere searched from October 2005 to February 2017 to collect before-after controlled studies about the efficacy of Mitra Clip therapy in heart failure patients with mitral insufficiency.There are two reviewers screened literature independently,and extracted data.Meanwhile,they assessed the methodological quality of included studies.Then,meta-analysis was performed by Rev Man 5.2 software.Results There were total of 10 studies involving 1091 patients included.The results of metaanalysis idicated that,compared with their conditions before treatment,patients after the Mitra Clip implantation had increased left ventricular ejection fraction(LVEF)(MD= –2.97,95%CI –5.06 to –0.89,P=0.005),declined NYHA class III-IV ratio(OR=72.87,95%CI(38.14,139.23),P<0.00001),P<0.000 01),,and reduced mitral regurgitation(OR=539.35,95%CI(307.29,946.64),P<0.00001),P<0.000 01).There was heterogeneity in the results of six minute walk test(I2=94%,P=0.01),considering causing by the baseline,follow-up time heterogeneity.Because of the few number of the studies,it is not for subgroup analysis,but the 6 minutes walking distance average were significantly increased in all of the studies comparing with the preoperative.Conclusion Mitra Clip therapy can,to a certain extent,improve the cardiac function of patients with heart failure and mitral insufficiency,and reduced mitral regurgitation.However,further studies are needed to confirm its effects on improving the long-term survival of patients.