title: Edge-to-edge percutaneous repair of severe mitral regurgitation--state-of-the-art for Mitraclip® implantation.
abstract: MitraClip® therapy is a percutaneous edge-to-edge plication of the mitral leaflets, mimicking the Alfieri surgical technique. MitraClip® implantation is a safe procedure, and survival outcomes in high-surgical-risk patients are superior to historical controls. Despite these results, questions remain concerning long-term efficacy and durability. The MitraClip® device has been studied in a safety and feasibility trial in the USA, a randomized pivotal trial against surgical mitral valve repair. Moreover, MitraClip® now has over 2 years of CE-mark approval and a rapidly expanding clinical experience in Europe, primarily in patients at high risk for surgery. A dedicated multidisciplinary team is necessary, as well as thoughtful patient selection, familiarity with the technical aspects of the procedure, including transesophageal ultrasound imaging and post-procedure monitoring. Currently available clinical data and procedural steps are herein reviewed. Because the MitraClip® procedure is still relatively new, continued investigation is required to further better define the patient populations that will benefit most.
authors.affiliation: Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alegria-Barrero
authors.forename: Pak Hei
authors.initials: PH
authors.lastname: Chan
authors.forename: Manuel
authors.initials: M
authors.lastname: Paulo
authors.forename: Alison
authors.initials: A
authors.lastname: Duncan
authors.forename: Susana
authors.initials: S
authors.lastname: Price
authors.forename: Neil
authors.initials: N
authors.lastname: Moat
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.forename: Antoni
authors.initials: A
authors.lastname: Serra
authors.forename: Eulogio
authors.initials: E
authors.lastname: García
authors.forename: Olaf
authors.initials: O
authors.lastname: Franzen
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D018579:Patient Selection; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013525:Surgical Instruments; D016896:Treatment Outcome