Echocardiographic and Clinical Outcomes of MitraClip Therapy in Patients Not Amenable to Surgery

Rudolph, Volker; Knap, Malgorzata; Franzen, Olaf; Schlüter, Michael; Vries, Tjark de; Conradi, Lenard; Schirmer, Johannes; Treede, Hendrik; Wegscheider, Karl; Costard‐Jäckle, Angelika; Meinertz, Thomas; Reichenspurner, Hermann; Baldus, Stephan

doi:10.1016/j.jacc.2011.07.047

Cited by 130 publications

(78 citation statements)

References 8 publications

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“…The exclusion criteria used were different from the commonly applied EVEREST criteria. 4 For degenerative MR, patients were considered unsuitable if (1) flail width was >25 mm and gap was >12 mm; (2) flail leaflets did not have secondary chordae support; (3) baseline mitral valve area (MVA) was <3.5 cm 2 and (4) there was excessive Barlow disease with multiple jets. For those with functional MR who had a central jet, patients were considered contraindicated for the procedure if (1) the gap between 2 leaflets was >3 mm; (2) there was a posteriororiented posterior mitral leaflet (PML) in a posterior wall aneurysm; and (3) there was a small baseline MVA <3.5 cm 2 with restrictive anterior mitral leaflet (AML).…”

Section: Mitraclip For Severe Mrmentioning

confidence: 99%

Real-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation

Chan

She

Alegría-Barrero

et al. 2012

Circ J

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Section: Mitraclip For Severe Mrmentioning

confidence: 99%

Real-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation

Chan

She

Alegría-Barrero

et al. 2012

Circ J

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“…Subsequent nonrandomized studies of MitraClip have consistently shown clinically meaningful improvements in hemodynamic, echocardiographic, and quality of life measures, even with moderate residual MR present. [14][15][16] These findings imply that even modest reduction of MR is beneficial. However, it is not clear how much improvement in MR severity is necessary to result in reverse remodeling of the LV or LA.…”

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confidence: 97%

Relationship Between the Magnitude of Reduction in Mitral Regurgitation Severity and Left Ventricular and Left Atrial Reverse Remodeling After MitraClip Therapy

et al. 2013

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Background-MitraClip has been shown to reduce mitral regurgitation (MR) severity safely but to a lesser degree than surgery. No data exist on the magnitude of MR reduction necessary to reverse left ventricular (LV) and left atrial (LA) dilation in patients with severe MR. Therefore, an analysis was performed to evaluate the relationship between MR reduction and LV and LA volumes after MitraClip therapy. Methods and Results-A total of 801 patients treated with MitraClip and 80 patients treated surgically were included. All patients had severe (3-4+) MR. MR severity, LV volumes at end-diastole and end-systole, and LA volumes were measured at baseline, discharge, 30 days, 6 months, and 1 year by an independent echocardiographic core laboratory. A linear repeated measures model was developed to determine the relationship between MR severity and time of measurement postindex procedure on longitudinal LV and LA volumes. Separate models were fit for functional MR and degenerative MR. In both degenerative and functional MR, reduction in LV volumes at end-diastole was associated with degree of residual MR at 12 months (P<0.0001). LV volumes at end-systole was significantly reduced in functional MR but not degenerative MR. LA volumes were significantly related to reduction of MR severity in both groups. Conclusions-Reduction of LV volumes at end-diastole and LA volumes, but not LV volumes at end-systole in degenerative MR, is consistent with correction of volume overload from primary MR. Reduction of all 3 measurements in functional MR demonstrates reverse remodeling when MR severity is reduced to either 1+ or 2+ by MitraClip therapy. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00209274.

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“…[16][17][18][19][20][21][22][23][24][25][26][27] A recent pooled analysis of 351 patients in the EVEREST II High Risk Registry and the REALISM (Real World Expanded Multi-center Study of the MitraClip System) Continued Access Study demonstrated an implantation success of 96%. 19 These patients were all considered high risk for surgery (estimated Society of Thoracic Surgeons score >12%).…”

Section: Evidence From Registriesmentioning

confidence: 99%

Current Status and Clinical Development of Transcatheter Approaches for Severe Mitral Regurgitation

Grasso

Capodanno

Tamburino

et al. 2015

Circ J

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Transcatheter mitral valve intervention has emerged as an effective treatment option for symptomatic severe mitral regurgitation in patients considered to be inoperable or at high operative risk for surgical mitral valve surgery. Most transcatheter approaches are modifications of existing surgical approaches. Transcatheter edge-to-edge mitral valve repair with the MitraClip system has the largest clinical experience to date, as it offers a sustained clinical benefit in selected patients. This review aims to provide an up-to-date overview of transcatheter mitral valve interventions, including leaflet repair, annuloplasty, and mitral valve implantation. (Circ J 2015; 79: 1164 -1171

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Echocardiographic and Clinical Outcomes of MitraClip Therapy in Patients Not Amenable to Surgery

Abstract: MitraClip therapy improves clinical and echocardiographic outcomes at 1 year in about three-quarters of critically ill, elderly patients with moderate to severe MR not amenable to surgery.

Cited by 130 publications

References 8 publications

Real-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation

Real-World Experience of MitraClip for Treatment of Severe Mitral Regurgitation

Relationship Between the Magnitude of Reduction in Mitral Regurgitation Severity and Left Ventricular and Left Atrial Reverse Remodeling After MitraClip Therapy

Current Status and Clinical Development of Transcatheter Approaches for Severe Mitral Regurgitation

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