title: [Percutaneous treatment of mitral valve regurgitation: Initial experience with the MitraClip device].
abstract: BACKGROUND
  Mitral regurgitation (MR) is the most common valvular disease and has recently become the target of a number of percutaneous approaches. The MitraClip is virtually the only device for which there is considerable experience, with more than 20,000 procedures performed worldwide.
  
  
  OBJECTIVE
  To describe our initial experience of the percutaneous treatment of MR with the MitraClip device.
  
  
  METHODS
  We describe the first six MitraClip cases performed in this institution (mean age 58.5 ± 13.1 years), with functional MR grade 4+ and New York Heart Association (NYHA) heart failure class III or IV (n=3), with a mean follow-up of 290 ± 145 days.
  
  
  RESULTS
  Procedural success (MR ≤ 2+) was 100%. Total procedure time was 115.8 ± 23.7 min, with no in-hospital adverse events and discharge between the fourth and eighth day, and consistent improvement in the six-minute walk test (329.8 ± 98.42 vs. 385.33 ± 106.95 m) and in NYHA class (three patients improved by two NYHA classes). During follow-up there were two deaths, in two of the four patients who had been initially considered for heart transplantation.
  
  
  CONCLUSIONS
  In patients with functional MR the MitraClip procedure is safe, with both a high implantation and immediate in-hospital success rate. A longer follow-up suggests that the clinical benefit decreases or disappears completely in patients with more advanced heart disease, namely those denied transplantation or on the heart transplant waiting list.
authors.affiliation: Serviço de Cardiologia, Hospital S. Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal. Electronic address: dcacela@hotmail.com.
authors.forename: Duarte
authors.initials: D
authors.lastname: Cacela
authors.affiliation: Serviço de Cardiologia, Hospital S. Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Fiarresga
authors.affiliation: Serviço de Cardiologia, Hospital S. Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Luísa
authors.initials: L
authors.lastname: Branco
authors.affiliation: Serviço de Cardiologia, Hospital S. Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Galrinho
authors.affiliation: Serviço de Cardiologia, Hospital S. Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Rio
authors.affiliation: Serviço de Cardiologia, Hospital S. Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Mafalda
authors.initials: M
authors.lastname: Selas
authors.affiliation: Serviço de Cardiologia, Hospital S. Marta, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Ferreira
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods
keywords: Functional mitral regurgitation; Insuficiência mitral; Insuficiência mitral funcional; MitraClip; Mitral regurgitation; Percutaneous mitral valve repair; Reparação percutânea da válvula mitral