title: The evolution of percutaneous mitral valve repair therapy: lessons learned and implications for patient selection.
abstract: Mitral regurgitation (MR) is the most common valve disease in the United States. However, a significant number of patients are denied surgery due to increased age, poor ventricular function, or associated comorbidities, putting them at high risk for adverse events. Moreover, the benefit of surgery for MR is unclear in patients with functional (secondary) MR. Recently, percutaneous repair of the mitral valve with a particular device (MitraClip, Abbott, Menlo Park, California) has emerged as a novel therapeutic option for patients with secondary MR or those deemed to be high risk for surgery. We review data from its initial concept through clinical trials and current data available from several registries. We focused on lessons learned regarding adequate patient selection, along with current and future perspectives on the use of device therapy for the treatment of MR.
authors.affiliation: The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California; The Heart Institute, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Roy
authors.initials: R
authors.lastname: Beigel
authors.affiliation: Cardiovascular Center Darmstadt, Darmstadt, Germany.
authors.forename: Nina C
authors.initials: NC
authors.lastname: Wunderlich
authors.affiliation: The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Saibal
authors.initials: S
authors.lastname: Kar
authors.affiliation: The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address: Robert.siegel@cshs.org.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Siegel
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D002986:Clinical Trials as Topic; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D018570:Risk Assessment
keywords: mitral valve; mitral valve annuloplasty; mitral valve insufficiency; outcomes assessment; patient selection