title: Preliminary experience using the transcatheter mitral valve leaflet repair procedure.
abstract: BACKGROUND
  Mitral regurgitation (MR) causes increased morbidity and mortality in heart failure patients and is often associated with augmented surgical risk.
  
  
  OBJECTIVE
  To assess the preliminary results oftranscatheter mitral valve leaflet repair (TMLR) in a single academic center.
  
  
  METHODS
  Data were collected prospectively in the cardiology department of Rabin Medical Center in 2012. Ten consecutive patients (age 69.3 +/- 15.9 years, ejection fraction 36.5 +/- 9.4) who were poor surgical candidates with severe functional MR underwent general anesthesia, followed by trans-septal puncture and a TMLR procedure using the MitraClip device.
  
  
  RESULTS
  All 10 patients were considered to have severe functional MR prior to TMLR treatment and were all symptomatic; the mean New York Heart Association (NYHA) class was 3.4 +/- 0.5. The MR severity was 4 +/- 0. There were no immediate complications or failures of the procedure. One patient died on day 5 due to massive gastrointestinal bleeding. Immediately following TMLR all 10 patients showed a profound MR reduction to a mean severity grade of 1.6 +/- 0.6. At one month after the procedure, NYHA had decreased to an average of 1.7 +/- 1.0 and was at least grade 2 in all but one patient. After 6 months the MR remained < or = 2 in six of eight patients, with a NYHA average of 1.4 +/- 0.5.
  
  
  CONCLUSIONS
  The MitraClip procedure was shown to be relatively safe, providing significant clinical benefit to a relatively sick population with severe MR. It is therefore an important alternative to surgery in these high risk patients.
authors.affiliation: Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel. l-perl@013.net
authors.forename: Leor
authors.initials: L
authors.lastname: Perl
authors.forename: Moti
authors.initials: M
authors.lastname: Vaturi
authors.forename: Abid
authors.initials: A
authors.lastname: Assali
authors.forename: Yaron
authors.initials: Y
authors.lastname: Shapira
authors.forename: Elchanan
authors.initials: E
authors.lastname: Bruckheimer
authors.forename: Tuvia
authors.initials: T
authors.lastname: Ben-Gal
authors.forename: Hana
authors.initials: H
authors.lastname: Vaknin-Assa
authors.forename: Alik
authors.initials: A
authors.lastname: Sagie
authors.forename: Ran
authors.initials: R
authors.lastname: Kornowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D015331:Cohort Studies; D017548:Echocardiography, Transesophageal; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013318:Stroke Volume; D016896:Treatment Outcome