title: Comparative effectiveness of Mitraclip plus medical therapy versus medical therapy alone in high-risk surgical patients: a comprehensive review.
abstract: In recent years, Mitraclip has become available as a treatment option for mitral regurgitation in high-risk surgical patients. Focusing on the incremental effectiveness of Mitraclip versus the current standard of care, this article provides a comparative review of the evidence on Mitraclip and standard medical therapy (MT) in high-risk mitral regurgitation patients. Evidence was retrieved from seven major databases. Results suggest that Mitraclip presents a high safety profile and a good middle-term effectiveness performance. Evidence on long-term effectiveness is limited both for Mitraclip and MT. Few studies allow a comparison with MT and comparative results on different endpoints are mixed. Therefore, the available evidence does not conclusively inform whether or under which circumstances Mitraclip should be preferred over MT in the treatment of high-risk patients. Head-to-head real-world studies would be needed, as they would provide great and timely insights to support policy decisions when medical devices are at stake.
authors.affiliation: Centre for Research on Health and Social Care Management (CERGAS), Università Bocconi, Milan, Italy.
authors.forename: Fernando Matias
authors.initials: FM
authors.lastname: Gonzalez
authors.forename: Aureliano Paolo
authors.initials: AP
authors.lastname: Finch
authors.forename: Patrizio
authors.initials: P
authors.lastname: Armeni
authors.forename: Paola Roberta
authors.initials: PR
authors.lastname: Boscolo
authors.forename: Rosanna
authors.initials: R
authors.lastname: Tarricone
mesh_terms: D016208:Databases, Factual; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D019736:Prostheses and Implants
keywords: Mitraclip; effectiveness; medical therapy; mitral regurgitation; review