Percutaneous Mitral Valve Repair for Mitral Regurgitation in High-Risk Patients

Glower, Donald D.; Kar, Saibal; Trento, Alfredo; Lim, D. Scott; Bajwa, Tanvir; Quesada, Ramon; Whitlow, Patrick L.; Rinaldi, Michael; Grayburn, Paul A.; Mack, Michael J.; Mauri, Laura; McCarthy, Patrick M.; Feldman, Ted

doi:10.1016/j.jacc.2013.12.062

Cited by 385 publications

(231 citation statements)

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“…A percutaneous MV repair device (overseas brand name MitraClip ® , Abbott Vascular, Santa Clara, CA, USA) has shown promise in reducing MR severity and improving clinical and functional outcomes and quality of life (QOL) in patients with severe MR. 3- 5 The MitraClip ® device, which simulates the Alfieri technique, 6 grasps and coapts the MV leaflets, resulting in fixed approximation of the leaflets throughout the cardiac cycle. This percutaneous procedure is performed without the need P rimary (or degenerative) mitral regurgitation (MR) is caused by a structural or degenerative abnormality of the mitral valve (MV) involving the leaflets, chordae tendineae, papillary muscles, or mitral annulus.…”

mentioning

confidence: 99%

AVJ-514 Trial　― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―

Hayashida

Yasuda

Matsumoto

et al. 2017

Circ J

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mentioning

confidence: 99%

AVJ-514 Trial　― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―

Hayashida

Yasuda

Matsumoto

et al. 2017

Circ J

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“…Secondary mitral regurgitation (MR) is a common consequence of left ventricular (LV) enlargement and dysfunction, but surgical repair has not been proven to be superior to medical therapy for functional MR. 32 Two recent non-randomised trials reported results of transcatheter mitral valve repair MitraClip in patients with severe MR who were deemed too high-risk for surgery. 33,34 In both studies more than 70 % of patients had functional MR. After mitral valve repair using MitraClip device, patients experienced improved clinical symptoms, …”

Section: Gaps In Device Therapymentioning

confidence: 92%

Gaps in the Heart Failure Guidelines

Tran

Fonarow

2014

European Cardiology Review

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“…The approval came in the wake of safety and efficacy data from several registries, observational studies, and pooled analyses in high-risk patients. 19,20 An integrated high surgical risk primary MR cohort was formed by pooling patients enrolled in the EVEREST (feasibility study of a percutaneous mitral valve repair system) II high-risk study and the later REALISM (real-world expanded multicenter study of Most recently Sorajja et al 21 reported acute, 30-day, and 1-year clinical outcomes of commercial transcatheter mitral valve repair with the MitraClip in the US on 2,952 high-risk patients (median age of 82 years and median STS score of 9.2%). Degenerative MR was found in 85.9% of the patients.…”

Section: Coaptation Techniquesmentioning

confidence: 99%

Percutaneous Treatment of Mitral Regurgitation: Present and Future

Athappan

Sorajja

Gössl

2017

Journal of the Minneapolis Heart Institute Foundation

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Mitral valve regurgitation poses a significant public health burden, with more than 3 million people in the US alone suffering from moderate or severe mitral valve regurgitation. Surgical correction with mitral valve repair or replacement is the mainstay of therapy. However, a significant proportion of elderly patients are not eligible for mitral valve repair or replacement due to prohibitive surgical risk from increased age, poor ventricular function, or associated comorbidities. Percutaneous mitral valve repair/ replacement techniques have been developed to fill this void. The most advanced percutaneous technique with the highest safety and efficacy to date is the edge-to-edge MitraClip repair system. The majority of other catheter-based mitral valve repair/ replacement devices are at early developmental stages, but have shown encouraging initial results in feasibility trials. Transcatheter mitral valve replacement holds promise to emerge as the leading transcatheter treatment of choice in the future. KEY WORDS degenerative MR, functional MR, MitraClip, TMVR n INTRODUCTIONMitral valve regurgitation (MR) poses a significant public health burden, with more than 3 million people in the US alone suffering from moderate or severe MR.1 Left untreated, chronic MR results in heart failure symptoms, left ventricular cavity dilation and systolic dysfunction, left atrial enlargement, atrial fibrillation (AF), and pulmonary hypertension. In patients with severe primary/degenerative MR, an early repair of the structural defect is crucial to avoid irreversible sequela.2 In patients with secondary/functional MR, optimal medical therapy is a key component in the treatment of the underlying cardiomyopathy and may provide relief from symptoms. However, unless the cardiomyopathy and secondary/functional MR improves significantly under therapy, surgical or interventional options need to be considered. 3 Surgical correction with mitral valve repair (MVRe) or replacement (MVR) remain the mainstay of therapy for primary and secondary MR. Even so, because of the invasive nature of open-heart surgery (OHS) and the frequent presence of comorbidities in this group, up to 50% of patients with severe MR may not be offered surgery.4 This is especially true for older patients with multiple comorbidities and those with impaired left ventricular function. As a result, percutaneous technology is poised to significantly alter the treatment paradigm for chronic MR. Percutaneous MVRe or MVR offers the potential benefit of decreased morbidity, improved recovery time, and shorter hospital stays compared with OHS. In this review we summarize the devices that have been developed for percutaneous transcatheter mitral valve repair or replacement and their preliminary clinical results. Anatomy of the Mitral Valve ComplexAn appreciation of the complex anatomy of the mitral valve is of importance to understand the challenges in development of percutaneous MVRe or MVR technologies and for selection of the most optimal repair/replacement technique.T...

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Percutaneous Mitral Valve Repair for Mitral Regurgitation in High-Risk Patients

Abstract: The percutaneous mitral valve device significantly reduced MR, improved clinical symptoms, and decreased LV dimensions at 12 months in this high-surgical-risk cohort. (Endovascular Valve Edge-to-Edge REpair STudy [EVERESTIIRCT]; NCT00209274).

Cited by 385 publications

References 20 publications

AVJ-514 Trial　― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―

AVJ-514 Trial　― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―

Gaps in the Heart Failure Guidelines

Percutaneous Treatment of Mitral Regurgitation: Present and Future

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Percutaneous Mitral Valve Repair for Mitral Regurgitation in High-Risk Patients

Abstract: The percutaneous mitral valve device significantly reduced MR, improved clinical symptoms, and decreased LV dimensions at 12 months in this high-surgical-risk cohort. (Endovascular Valve Edge-to-Edge REpair STudy [EVERESTIIRCT]; NCT00209274).

Cited by 385 publications

References 20 publications

AVJ-514 Trial ― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―

AVJ-514 Trial ― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―

Gaps in the Heart Failure Guidelines

Percutaneous Treatment of Mitral Regurgitation: Present and Future

Contact Info

Product

Resources

About

AVJ-514 Trial　― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―

AVJ-514 Trial　― Baseline Characteristics and 30-Day Outcomes Following MitraClip<sup>®</sup> Treatment in a Japanese Cohort ―