title: Preoperative evaluation before MitraClip®: present and future perspective.
abstract: Mitral regurgitation (MR) is the second most common heart valve disease worldwide. Currently, the management of MR is based on medical therapy (including biventricular pacing), surgery (mitral valve replacement or repair) and percutaneous therapy. However, in spite of guideline recommendations, 50% of individuals assessed in the Euro Heart Survey were not referred to surgical intervention due to comorbidities or real or perceived high risks for cardiac surgery; thus, in recent years, the focus of research has shifted to the development of percutaneous approaches to treat severe MR in order to restore valve function in a minimally invasive fashion. Among these techniques, the percutaneous mitral valve repair procedure using the MitraClip(®) system (Abbott Vascular, IL, USA) is one of the most promising. Usually, patient selection for MitraClip implantation is based on careful echocardiographic assessment of valve disease; however, although definitive data are lacking, evidence is mounting for a multiparametric approach including the evaluation of the functional status of patients.
authors.affiliation: Department of Cardiology, Second University of Naples, Ospedale dei Colli, Naples, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Salerno
authors.forename: Frank Patrick
authors.initials: FP
authors.lastname: Schmidt
authors.forename: Maurizio Cappelli
authors.initials: MC
authors.lastname: Bigazzi
authors.forename: Chiara
authors.initials: C
authors.lastname: Sordelli
authors.forename: Renato
authors.initials: R
authors.lastname: Bianchi
authors.forename: Paolo
authors.initials: P
authors.lastname: Golino
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabrò
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Russo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pacileo
mesh_terms: D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D018579:Patient Selection; D011300:Preoperative Care
keywords: MitraClip® procedure; cardiopulmonary exercise test; echocardiography; mitral regurgitation; percutaneous intervention