Managing mitral regurgitation: focus on the MitraClip device.
Based on the principle of surgical edge-to-edge mitral valve repair (MVR), the MitraClip percutaneous MVR technique has emerged as a minimally invasive option for MVR. This catheter-based system has been widely demonstrated to be safe, although inferior to surgical MVR. Studies examining patients with ≥3+ mitral regurgitation (MR) show that, for all patients treated, freedom from death, surgery, or MR ≥3+ is in the 75%-80% range 1 year following MitraClip implantation. Despite its inferiority to surgical therapy, in high-risk surgical patients, data suggest that the MitraClip system can be employed safely and that it can result in symptomatic improvement in the majority of patients, while not precluding future surgical options. MitraClip therapy also appears to reduce heart failure readmissions in the high-risk cohort, which may lead to an economic benefit. Ongoing study is needed to clarify the impact of percutaneous mitral valve clipping on long-term survival in high-risk populations, as well as its role in other patient populations, such as those with functional MR.
Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, Nashville, TN, USA.
J Trent
JT
Magruder
Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, Nashville, TN, USA.
Todd C
TC
Crawford
Division of Cardiac Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, Nashville, TN, USA.
Joshua C
JC
Grimm
Department of Medicine, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Joseph L
JL
Fredi
Department of Cardiac Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA.
Ashish S
AS
Shah
cardiac surgery; mitral clips; mitral regurgitation; percutaneous; transcatheter