title: Single-center experience with percutaneous mitral valve repair using the MitraClip in a high-risk series in Turkey.
abstract: OBJECTIVE
  Mitral valve regurgitation (MR) is the second most common heart valve disease in Europe. Without intervention, prognosis of severe symptomatic MR is poor. Percutaneous edge-to-edge mitral valve repair with MitraClip is a promising mitral regurgitation treatment technique in select, high-surgical-risk patients. The present objective was to describe the experience of a single center with MitraClip use in a high-risk series in Turkey.
  
  
  METHODS
  Between May 2013 and September 2014, 28 high-surgical-risk patients with MR of at least grade 3+ and mean EuroSCORE of 26% underwent MitraClip implantation at our institution. In-hospital and follow-up safety and efficacy results are presented.
  
  
  RESULTS
  Mean patient age was 58 years, and 75% were male. Grade 3 or 4 MR was present in all patients, and was primarily the result of restrictive functional mitral regurgitation (in 89% of cases). Mean left ventricular ejection fraction (LVEF) was 27% and New York Heart Association (NYHA) classification was III or IV in 89% of the population. Acute procedural success was 89%, with 47% of patients receiving a single clip, 39% receiving 2 clips, and 14% receiving 3 clips. One periprocedural death occurred, and 2 deaths occurred during follow-up (mean: 13.9 months). After 1 year, more than 75% of patients had MR severity of ≤2+ and NYHA classification of I or II, but no significant change in left ventricular volume or systolic function. Significant improvement in 6-minute walk test and quality of life was also observed.
  
  
  CONCLUSIONS
  Initial experience with the MitraClip system showed promising results in patients considered high-surgical-risk, particularly in those with end-stage heart failure.
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey. cuneytoprak@hotmail.com.
authors: Cüneyt
authors: C
authors: Toprak
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Gökhan
authors: G
authors: Kahveci
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Alev
authors: A
authors: Kılıçgedik
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Cevat
authors: C
authors: Kırma
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Selçuk
authors: S
authors: Pala
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Mustafa
authors: M
authors: Bulut
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Cihangir
authors: C
authors: Kaymaz
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Nihal
authors: N
authors: Özdemir
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: İbrahim Akın
authors: İA
authors: İzgi
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Mehmet
authors: M
authors: İnanır
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Anıl
authors: A
authors: Avcı
authors: Department of Cardiology, Kartal Koşuyolu Heart Training and Research Hospital, İstanbul, Turkey.
authors: Ali Metin
authors: AM
authors: Esen
mesh_terms: D000368:Aged; D057510:Endovascular Procedures / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery; D011446:Prospective Studies; D014421:Turkey