title: Prevalence of severe mitral regurgitation eligible for edge-to-edge mitral valve repair (MitraClip).
abstract: OBJECTIVE
  We assessed the prevalence of moderately severe or severe mitral regurgitation (MR) justifying edge-to-edge mitral valve (MV) repair (MitraClip(®)) in patients attending the University Hospital Wuerzburg, a tertiary care centre located in Wuerzburg, Germany.
  
  
  BACKGROUND
  Transcatheter edge-to-edge MV repair of advanced MR is a non-surgical treatment option in inoperable and high-risk patients. It is unknown how many patients are potentially eligible for MitraClip(®) since several anatomical prerequisites of the MV apparatus have to be met for optimal treatment results.
  
  
  METHODS
  Using a novel clinical data warehouse we searched for all patients attached to our Department of Internal Medicine from 01/2008 to 01/2012 with moderately severe or severe MR and aged ≥18 years. The current status of their treatment regime and eligibility for MitraClip(®) was assessed and re-evaluated according to current guidelines and echocardiographic criteria.
  
  
  RESULTS
  The search of electronic medical records amongst 43,690 patients employed an innovative validated text extraction method and identified 331 patients with moderately severe or severe MR who had undergone echocardiographic assessment at our institution. Of these, 125 (38 %) received MV surgery and 206 (62 %) medical therapy only. Most patients not undergoing surgery had secondary MR (70 %). After evaluation of medical and echocardiographic data of medically treated patients (n = 206), 81 (39 %) were potential candidates for MitraClip(®) therapy, and 90 (44 %) died during the median follow-up time of 23 months.
  
  
  CONCLUSIONS
  A large fraction of patients with moderately severe or severe MR but not operated was detected. Medically treated patients had a bad prognosis and about 40 % of them were potential candidates for MitraClip(®) therapy.
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Wallenborn
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Herrmann
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
authors.forename: Olga
authors.initials: O
authors.lastname: Kukuy
authors.affiliation: Department of Informatics VI, University of Würzburg, Würzburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Fette
authors.affiliation: Department of Informatics VI, University of Würzburg, Würzburg, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Puppe
authors.affiliation: Department of Cardiothoracic Surgery, Univerity Hospital Würzburg, Würzburg, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Gorski
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Hu
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Voelker
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.affiliation: Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany. f.weidemann@katharinen-hospital.de.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. f.weidemann@katharinen-hospital.de.|Innere Medizin II, Katharinen-Hospital Unna, Obere Husemannstrasse 2, 59423, Unna, Germany. f.weidemann@katharinen-hospital.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Weidemann
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D015150:Echocardiography, Doppler; D057286:Electronic Health Records; D005260:Female; D005858:Germany / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D018579:Patient Selection; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Mitraclip; Mitral regurgitation; Prevalence