CClinicalTrials.gg
Active, not recruitingNCT03271762MITRA-HRUpdated Nov 26, 2025

Multicentre Study of MITRACLIP® Transcatheter Mitral Valve Repair in Patients With Severe Primary Mitral Regurgitation Eligible for High-risk Surgery

An interventional study of percutaneous mitral valve repair with MITRACLIP NT, MITRACLIP NTR/XTR, MITRACLIP G4NT/XT, MITRACLIP G4NTW/XTW and cardiac surgery in Mitral Regurgitation, sponsored by Nantes University Hospital. Active, not recruiting at 31 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-11-26.

Sponsored by Nantes University Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
330
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The objective of the study is to demonstrate the non-inferiority for clinical efficacy of an endovascular treatment strategy with the MitraClip® in comparison with a surgical treatment strategy in patients with severe primary mitral regurgitation judged eligible for anatomical repair with the MitraClip® or mitral valve surgery with high surgical risk.

This trial is a French and Monegasque, multicenter and randomized trial. Patients enrolled will be clinically followed for 2 years ( clinical visit at 1 month, at 6 months and 12 months, phone call at 18 months and clincial visit at 24 months).

02

Conditions studied

  • Mitral Regurgitation

Keywords

  • MITRACLIP
  • primary Mitral Regurgitation
  • high surgical risks
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Primary Mitral Regurgitation grade 3+ or 4+

  • Patients in class II to IV NYHA
  • Mitral valve anatomy appropriate to MitraClip® therapy and mitral valve surgery
  • Adult patients judged eligible for mitral valve surgery by the local heart team but at high surgical risk defined as: age ≥ 75 years and STS score ≥ 6 % or one frailty index or one major organ system compromise or one possible procedure-specific impediment (using MVARC definitions) ; or age \< 75 years and STS score > 8 % or at least one other high-risk criterion following the MVARC definitions; or age > 80 years and judged at high risk for surgery by the local heart team
  • Isolated Mitral valve pathology
  • If revascularization procedures are required, they must be performed more than 30 days from intervention (D0)
  • Patients affiliate to social security

Non-inclusion Criteria:

  • Life expectancy \< 1 year due to non-cardiac conditions
  • Secondary Mitral regurgitation
  • Evolving endocarditis or active endocarditis or inflammatory disease in the last 3 months
  • Patient who cannot tolerate procedural anticoagulation or post procedural antiplatelet regimen
  • Rheumatic mitral valve disease
  • Evidence of intracardiac, inferior vena cava or femoral venous thrombus
  • Valve anatomy not compatible with MitraClip® implantation (cf. colum 3 table 3 page 57)
  • Stroke or transient ischaemic event within 30 days before D0
  • Modified Rankin Scale ≥4 disability (appendix 9)
  • TAVR within 30 days before D0-Untreated, clinically significant coronary artery disease requiring revascularization
  • Any percutaneous cardiovascular intervention within 30 days before D0 including ATC
  • Cardiovascular surgery, or carotid surgery within 30 days before D0
  • Any prior mitral valve surgery or transcatheter mitral valve procedure
  • Need for any concomitant cardiac surgery including treatment of severe secondary tricuspid regurgitation in accordance with class I recommendation in 2017 ESC guidelines. Surgical treatment of mild or moderate secondary tricuspid regurgitation (Class IIa and IIb recommendations) can still be performed in the protocol according to the local heart team decison
  • NYHA functional class I
  • LVEF \< 30%
  • Primary MR grade 1 to 2
  • Subjects in whom transesophageal echocardiography or transseptal catheterization are contraindicated or high-risk
  • Any condition preventing the patient from completing all protocol procedures (including compliance with guidelines directed medical therapy) and follow-up visits
  • Patient unable or unwilling to provide written, informed consent before study enrolment
  • Pregnant or nursing women
  • Vulnerable people: persons deprived of liberty; under trusteeship or under curatorship
  • Participation in another trial that would interfere with this trial

Exclusion criteria

Exclusion criteria

  • Not eligible for a MitraClip® intervention after Core Lab evaluation
  • Before randomization (D-21) the patient no longer fulfills eligibility criteria (inclusion criteria and non-inclusion criteria)
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
330 participants (estimated)

Study arms

  • Experimental
    MITRACLIP NT, MITRACLIP NTR/XTR, MITRACLIP G4NT/XT, MITRACLIP G4NTW/XTW Device

    MitraClip NT System includes a MitraClip device, a steerable guide catheter and a MitraClip delivery system

    Device: percutaneous mitral valve repair with MITRACLIP NT, MITRACLIP NTR/XTR, MITRACLIP G4NT/XT, MITRACLIP G4NTW/XTW

  • Active comparator
    cardiac surgery

    mitral valve repair in first intervention, valve replacement if repair not feasible

    Procedure: cardiac surgery

Interventions

  • Devicepercutaneous mitral valve repair with MITRACLIP NT, MITRACLIP NTR/XTR, MITRACLIP G4NT/XT, MITRACLIP G4NTW/XTW

    percutaneous mitral valve repair Percutaneous MitraClip Device Implantation

    Also known as: MITRACLIP

  • Procedurecardiac surgery

    mitral valve repair or mitral valve remplacement

05

What researchers measure

Primary outcomes

  1. All-cause mortality, unplanned hospitalizations for heart failure and mitral valve reintervention

    comparison between arms of: * number and reason of death * number and reason unplanned rehospitalisation for cardiovascular reasons, * number of mitral valve reintervention

    Time frame: 12 months

Secondary outcomes

  1. occurrence of a major adverse event

    all-cause death, need for non-elective cardiovascular or thoracic surgery, device or procedure-related adverse events, major bleeding complications or serious bleeding, major access site vascular complications, major cardiac structural complications, pulmonary complications (device or procedure-related), stroke and other cerebrovascular events, myocardial infarction, acute kidney injury or progression of chronic kidney disease, arrhythmias and conduction system disturbances, unplanned mitral valve surgery due to device/procedure failure or malfunction, requirement for valve replacement after valve repair failure, unplanned cardiac surgery for any cause

    Time frame: 30 days

Other outcomes

  1. Overall rate of surgery related Serious Adverse Events (SAEs) and Serious Adverse Device Effects (SADEs) Effects (SADEs)

    SAEs et SADEs rate related to protocol procedure all SAEs and SADEs

    Time frame: 6, 12 and 24 months

  2. all-cause mortality

    Rate of global mortality (all-causes)

    Time frame: 30 days and 6, 12 and 24 months

  3. cardiovascular mortality

    Rate of cardiovascular mortality

    Time frame: 30 days and 6, 12 and 24 months

  4. unplanned heart failure rehospitalization

    Rate of unplanned heart failure rehospitalization

    Time frame: 6, 12 and 24 months

  5. unplanned rehospitalization rate for cardiovascular reasons

    Rate of unplanned rehospitalization for cardiovascular reasons

    Time frame: 30 days 6, 12 and 24 months

  6. mitral valve reintervention

    Mitral valve reintervention rate

    Time frame: 30 days 6, 12 and 24 months

  7. residual MR

    MR (Mitral Regurgitation): grade

    Time frame: 30 days 6, 12 and 24 months

  8. left and right chamber remodelling and parameters (dimension)

    End-systolic dimension End-diastolic dimension Left atrial dimension

    Time frame: baseline, 30 days and 12 months

  9. left and right chamber remodelling and parameters (volume)

    End-systolic volume End-diastolic volume Left atrial volume

    Time frame: baseline, 30 days and 12 months

  10. left ventricular ejection fraction modification

    Left ventricular ejection fraction

    Time frame: baseline, 30 days and 12 months

  11. mitral valve remodelling

    Mitral valve area and mean gradient

    Time frame: baseline, 30 days and 12 months

  12. Left atrial and pulmonary artery pressures

    Left atrial and pulmonary artery pressures

    Time frame: baseline, 30 days and 12 months

  13. change in 6-minute Walking Test (functional evaluation)

    6-minute Walking Test

    Time frame: baseline, 6 and 12 months

  14. surveillance of cardiac and renal function

    NT ProBNP or BNP creatininemia, ureamia

    Time frame: baseline, 30 days, 6, 12 and 24 months

  15. change in Quality of Life scores

    Quality of Life EQ-5D score SF-36 score

    Time frame: baseline, 30 days, 6, 12 and 24 months

  16. Cost-effectiveness analysis (economic efficiency)

    Incremental cost-effectiveness ratio (cost per Quality-Adjusted Life-Year, QALY)

    Time frame: 24 months

06

Study locations

31 sites
  • Chu Angers
    Angers, France
  • Ch Annecy
    Annecy, 74370, France
  • Chu Bordeaux
    Bordeaux, France
  • Chru Brest
    Brest, France
  • Hopital Henri Mondor Aphp
    Créteil, France
  • Chu Grenoble
    Grenoble, France
  • Centre Chirurgical Marie Lannelongue
    Le Plessis-Robinson, France
  • Chru Lille
    Lille, 59000, France
  • Hopital Prive Le Bois Lille
    Lille, 59000, France
  • Clinique de La Sauvegarde
    Lyon, 69009, France
  • CHU LYON
    Lyon, France
  • Hopital La Timone
    Marseille, France
  • Hopital St Joseph
    Marseille, France
  • Institut Hospitalier Jacques Cartier
    Massy, France
  • Clinique Du Millenaire
    Montpellier, 34000, France
  • Chu Nantes
    Nantes, France
  • Hopital Bichat
    Paris, France
  • Hopital Europeen Georges Pompidou
    Paris, France
  • Hopital La Pitie Salpetriere
    Paris, France
  • Institut Mutualiste Montsouris
    Paris, France
  • Chu Poitiers
    Poitiers, France
  • Chu Rennes
    Rennes, France
  • CHU de Rouen
    Rouen, France
  • CHU Félix Guyon
    Saint-Denis, 97400, France
  • Centre Cardiologique Du Nord
    Saint-Denis, France
  • Chu Saint Etienne
    Saint-Etienne, 42277, France
  • Hopital Civil Strasbourg
    Strasbourg, France
  • Clinique Pasteur
    Toulouse, France
  • Hopital Rangueil
    Toulouse, France
  • Chru Tours
    Tours, France
  • Clinique Du Tonkin
    Villeurbanne, 69100, France
07

Registry details

Key details

Study ID
NCT03271762
Lead sponsor
Nantes University Hospital
Collaborators
Ministère de la Santé, Abbott
Responsible party
Sponsor
First posted
Sep 5, 2017
Start date
Mar 2, 2018
Primary completion
Dec 2026 (estimated)
Completion
Jan 2028 (estimated)
Last update
Nov 26, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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