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

Chan, Pak Hei; She, Hoi Lam; Alegría-Barrero, Eduardo; Moat, Neil; Mario, Carlo Di; Franzen, Olaf

doi:10.1253/circj.cj-12-0379

Cited by 29 publications

(47 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, the predictive value of these measures is questionable because in clinical practice mainly patients with FMR at high surgical risk undergo MitraClip procedures, which were not investigated rigorously. 4,10 Nevertheless, clinical success rates of MitraClip procedures are consistently reported to be high, ranging between 75% and 95%, [11][12][13] and real-time 3D TEE has been established as an indispensable tool for patient selection, procedural guidance, and the evaluation of acute interventional success. 14 However, acute interventional goals predicting durable device-success are not well defined.…”

Section: Patient Selection and Definition Of Successful Tmvr With Thementioning

confidence: 99%

“…2,3 Only limited data are available on acute changes of the MV annular geometry after MitraClip implantation. 4 We hypothesized that interventional edge-to-edge repair of MR using the MitraClip system potentially reduces MV annular diameters because of immediate and persistent tension on the MV annulus via the anterior and posterior (AP) MV leaflets. Furthermore, we aimed to assess the correlation of acute anatomic changes in MV geometry with the patients functional outcomes after follow-up.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Acute Changes of Mitral Valve Geometry During Interventional Edge-to-Edge Repair With the MitraClip System Are Associated With Midterm Outcomes in Patients With Functional Valve Disease

Schueler

Momčilović

Weber

et al. 2014

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

Background-Transcatheter mitral valve repair (TMVR) is a treatment option in patients with symptomatic functional or degenerative mitral regurgitation (DMR) at high surgical risk. The acute effect of MitraClip procedure on mitral valve (MV) annular geometry and its relation to functional outcomes is unclear. We sought to assess immediate effect of TMVR on MV annular geometry with 3-dimensional (3D) transesophageal echocardiography and the association of MV diameter reduction with functional response after 6 months. , and MV annular geometry (MV sphericity index, 0.9±0.1 and 0.8±0.1; P<0.0001); the lateral medial MV diameters remained unchanged (4.3±0.7 and 4.4±0.6 cm; P=0.13). In subjects with DMR, all MV annular geometry-defining values were not significantly altered after TMVR (n=36; P>0.05). Acute anterior-posterior diameter reduction was associated with clinical response to TMVR after 6 months of follow-up (cutoff value, ≥6.4%; area under the curve, 0.81; P=0.002; sensitivity, 81.6%; specificity, 81.8%), which was confirmed by additional regression analysis (P=0.007). Conclusions-Three-dimensional transesophageal echocardiography enables assessment of acute changes of MV geometry in patients undergoing the MitraClip procedure. Only patients with functional mitral regurgitation experienced significant reduction of MV annular dimensions, which was associated with clinical response to TMVR. (Circ Cardiovasc Interv. 2014;7:390-399.) Methods and Results-Consecutive

show abstract

Section: Patient Selection and Definition Of Successful Tmvr With Thementioning

confidence: 99%

mentioning

confidence: 99%

Acute Changes of Mitral Valve Geometry During Interventional Edge-to-Edge Repair With the MitraClip System Are Associated With Midterm Outcomes in Patients With Functional Valve Disease

Schueler

Momčilović

Weber

et al. 2014

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

show abstract

“…This has led to a more conservative approach for elderly patients who suffer from mitral valve disease and sometimes an alternative technique, such as percutaneous treatment, is selected. 14,15) In terms of surgical techniques, mitral valve repair was initially considered to be an unnecessary procedure in elderly patients, but the repair rate continues to grow due to improvement in surgical techiniques. 10,[16][17][18] Detaint, et al reported that the repair rate has increased with time and exceeds 80% even in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Mitral Valve Repair for Degenerative Mitral Regurgitation in the Elderly

Murashita

Okada

Kanemitsu

et al. 2014

ATCS

View full text Add to dashboard Cite

Purpose: The number of elderly patients who require surgical treatment for mitral regurgitation (MR) is increasing. However, the feasibility and efficacy of mitral valve repair in elderly patients are unclear. Methods: We retrospectively reviewed 55 patients, aged ≥75 years, who underwent mitral valve repair for degenerative MR between 1991 and 2011. All patients were followed up for 4.7 ± 3.4 years. Results: The patients aged ≥75 years were more symptomatic and had a higher incidence of persistent atrial fibrillation and pulmonary hypertension than those aged <75 years. Thirty-day and in-hospital mortality was 1.8% and 7.3%, respectively, and the 5-year survival rate was 81.6% ± 5.8%. The leading cause of late death was stroke, which primarily occurred in patients with postoperative atrial fibrillation. Except for a single failure of repair due to technical reasons, there was no recurrence of severe MR or reoperation on the mitral valve. In the late follow-up period, the mean left ventricular diastolic diameter significantly decreased and the mean left ventricular ejection fraction was approximately 60%. Most patients had mild symptoms at follow-up. Conclusion: Mitral valve repair can provide satisfactory early as well as long-term outcomes and can preserve left ventricular function even in the elderly.

show abstract

“…However, its results with BD still remain obscure. While the device is frequently used for degenerative mitral valve regurgitation, successes with BD patients have remained low [63][64][65]. The surgical technique which the MitraClip mimics has shown favorable results for BD.…”

Section: Future Directionsmentioning

confidence: 99%

“…The surgical technique which the MitraClip mimics has shown favorable results for BD. However, a formal study as to the outcomes and survival of BD patients that undergo MitraClip placement has not been performed [63][64][65][66]. The other new intervention is transcatheter mitral valve implantation (TMVI) [67].…”

Section: Future Directionsmentioning

confidence: 99%