title: [Transcatheter mitral valve repair for patients not amenable to surgical correction: epidemiology, diagnosis, equiti of access, and economic impact].
abstract: Mitral regurgitation is the most common valvular heart disease in western world, with moderate to severe mitral regurgitation having a deep impact on prognosis, mortality and rehospitalizations. Advanced congestive heart failure is frequently complicated by mitral regurgitation, a pathologic condition that is often under-diagnosed. A significant proportion of patients with severe mitral regurgitation is not eligible for surgery (mitral valve repair or replacement) because of contraindications or excessive surgical risk. Therefore, the need for a less invasive treatment has led to the development of endovascular techniques; among them the MitraClip system, which mimics Alfieri's edge-to-edge surgical technique introduced in 2003, has gained widespread acceptance. More than 35 000 patients have been treated using this technique. Evidence from clinical studies suggests that the MitraClip system is effective in improving survival and quality of life in patients with severe mitral regurgitation, also reducing rehospitalization rates with substantial social and economic advantages. At present, in Italy, undertreatment of patients with severe mitral regurgitation not amenable to surgical correction is still significantly high, and remarkable inhomogeneity among regions is observed in the availability of the MitraClip procedure.
authors.affiliation: Cardiologia Interventistica, IRCCS Policlinico San Donato, San Donato Milanese (MI).
authors.forename: Francesco
authors.initials: F
authors.lastname: Bedogni
authors.affiliation: U.O. Cardiologia Diagnostica ed Interventistica, Fondazione CNR Regione Toscana G. Monasterio - Ospedale del Cuore, Massa.
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
authors.affiliation: Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Esposito
authors.affiliation: Dipartimento Cardiovascolare, Ospedale Ferrarotto, Università degli Studi, Catania.
authors.forename: Alessio Gaetano
authors.initials: AG
authors.lastname: La Manna
authors.affiliation: U.O.C. Cardiologia, Azienda USL Toscana Sudest, Grosseto.
authors.forename: Ugo
authors.initials: U
authors.lastname: Limbruno
authors.affiliation: U.O.C. Cardiologia Interventistica, Anthea Hospital, GVM Care & Research, Bari.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Marchese
authors.affiliation: Dipartimento Cardiovascolare, Ospedale Cardarelli, Napoli.
authors.forename: Ciro
authors.initials: C
authors.lastname: Mauro
authors.affiliation: Dipartimento Cardiovascolare, Ospedali Riuniti, Università degli Studi, Trieste.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Salvi
authors.affiliation: Cardiologia Interventistica, AOU Careggi, Firenze.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Santoro
authors.affiliation: Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Policlinico Universitario, Padova.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
authors.affiliation: Laboratorio di Emodinamica, U.O. Cardiologia, Ospedale G.B. Morgagni-L. Pierantoni, Forlì.
authors.forename: Fabio
authors.initials: F
authors.lastname: Tarantino
authors.affiliation: Dipartimento di Cardiologia, Ospedale degli Infermi, Rivoli (TO).
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Varbella
authors.affiliation: Cardiologia Interventistica, Ospedale San Camillo-Forlanini, Roma.
authors.forename: Roberto
authors.initials: R
authors.lastname: Violini
authors.affiliation: S.C. Cardiologia, Ospedale Santa Croce e Carle, Cuneo.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
mesh_terms: D006328:Cardiac Catheterization; D006297:Health Services Accessibility; D019918:Heart Valve Prosthesis Implantation / Q000191:economics / Q000379:methods*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*