title: [Percutaneous repair of mitral regurgitation: a new tool in the armamentarium for advanced heart failure?].
abstract: Mitral regurgitation (MR) is the second most common heart valve disease worldwide, requiring surgical intervention in Europe. The current gold-standard treatment is surgical repair or replacement. Despite clear international guidelines, many patients do not undergo surgical intervention due to comorbidities, real or perceived high risk for cardiac surgery. The treatment of patients with functional MR in advanced heart failure has unsatisfactory results in terms of long-term survival as shown by retrospective small surgical experiences even if there is weak evidence for beneficial effects on left ventricular remodeling and functional capacity. Nevertheless, the appropriateness and timing of valve surgery in patients with advanced heart failure remain controversial. Based on these results, the focus of research has shifted in recent years to the development of percutaneous approaches to treat severe MR, in order to restore valve function in a minimally invasive fashion. Currently, various percutaneous techniques are under investigation in clinical trials and others have been developed, based on the surgical principles of mitral valve repair. This article focuses on the percutaneous mitral valve repair procedure using the MitraClip system (Abbott Vascular, Abbott Park, Illinois, USA). This approach that reproduces the edge-to-edge technique described by Alfieri, is safe and effective in improving functional class and reducing rehospitalization rates for heart failure patients.
authors.affiliation: Ospedale Ferrarotto, Universita di Catania, Catania. gpussia@hotmail.com
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Ussia
authors.forename: Valeria
authors.initials: V
authors.lastname: Cammalleri
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scandura
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D006333:Heart Failure / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome