Aims: To analyze risk and outcomes of complications during and after MitraClip implantation using multicenter data from the prospective German Transcatheter Mitral Valve Interventions (TRAMI) registry. Methods and Results: Data of 828 patients (mean age: 76.0 [71-81] years, 327 (40%) females) undergoing MitraClip implantation in Germany between 2010 and 2013 were analyzed. Most patients (85%) underwent elective procedures with on average implantation of 1.4 6 0.6 clips. Emergent cardiac surgery was not required; a single patient died intraoperatively. During the in-hospital period, complications occurred in 215 (25.9%) patients, of which 106 (12.8%) were considered major. Major bleeding complications were among the most frequent major complications (7.4%), while rates of pericardial tamponade (1.9%) and clip-specific complications (embolization: 0%, partial clip detachment: 1.9%) were low. In-hospital death, stroke or myocardial infarction (MACCE) occurred in 2.2, 0.9, and 0% patients, respectively. Patients with complications appeared to be older and more critically ill preinterventionally; in-hospital mortality was significantly higher as compared to those without procedural complications. Conclusions: MitraClip implantation appears to be a safe treatment option with low rates of MACCE and clip-specific complications. Catheterization and Cardiovascular Interventions 86: 728-735 (2015) Nevertheless, MitraClip therapy is not without complications. Careful patient selection and improvements in preventing peri-procedural bleeding have the potential of reducing post-procedural complications and improving outcomes. V C 2015 Wiley Periodicals, Inc.

For the treatment of structural heart disease, current options in the catheterization laboratory include MitraClip® implantation for treating severe mitral regurgitation, transcatheter aortic valve implantation (TAVI), closure of a patent foramen ovale (PFO) and occlusion of the left atrial appendage (LAA). These treatment options are based on a precise diagnosis provided by modern cardiac imaging, which is indispensable for treatment recommendations. Its importance for supporting the invasive procedures in the catheterization laboratory is less well known. Due to enhanced soft tissue characterization, it complements fluoroscopy and invasive angiography and thus enormously improves the safety of the procedures. In addition, it allows individualized follow-up care. The current article gives an overview of the clinically most frequently used procedures.

Abb. 2: Die gepoolte Analyse einer Metaanalyse von vier randomisierten Studien, die eine Behandlung via perkutaner Intervention (PCI) mit der einer aortokoronaren Bypass-Operation (ACB) zur Therapie der koronaren Herzerkrankung mit relevanten Haupt-stammstenosen vergleichen, zeigte ein ähnliches Auftreten des kombinierten Endpunktes aus Tod, Herzinfarkt oder zerebraler Ischämie. Lediglich die NOBLE-Studie sieht Vorteile für die ACB. In Abb. 2 ist leider ein Fehler vorhanden. Versehentlich wurden die Daten zu Tod, Herzinfarkt, Schlaganfall und TLR ("target lesion revascularization") in die Abbil-dung integriert. Richtig ist die Darstellung des kombinier-ten Endpunktes aus Tod, Herzinfarkt oder Schlaganfall ohne TLR. Wir bitten den Fehler zu entschuldigen. In den Kommentar von Prof. Eggebrecht zur ABSORB-III-Studie hat sich bei der redaktionellen Bearbeitung ein Fehler eingeschli-chen, der die Aussage des Kommentators verkehrt. Statt "…Beim ACC 2017 wurden nun die Langzeitergebnisse von ABSORB III vorgestellt. Nach nunmehr 25 Monaten zeigte sich ein signikanter Unterschied zugunsten des BVS:…" muss es richtig heißen "…Nach nunmehr 25 Monaten zeigte sich ein signikanter Unterschied zuungunsten des BVS:…" Wir bitten diesen Fehler zu entschuldigen. Die Redaktion Zitierweise: ABSORB-III-Studie: Bioresorbierbarer Stent auf holprigem Weg.