PMID- 24645227
OWN - NLM
STAT- MEDLINE
DCOM- 20140407
LR  - 20191210
IS  - 1565-1088 (Print)
VI  - 16
IP  - 2
DP  - 2014 Feb
TI  - MitraClip implantation for high risk patients with severe mitral regurgitation: 
      the Sheba experience.
PG  - 91-5
AB  - BACKGROUND: Percutaneous edge-to-edge mitral valve repair using the MitraClip 
      system has evolved as a new tool in the treatment of mitral regurgitation (MR). 
      OBJECTIVES: To present our initial experience with MitraClip implantation in 20 
      high risk patients at Sheba Medical Center. METHODS: Twenty high surgical risk 
      patients with symptomatic significant MR underwent MitraClip implantation. 
      Clinical and echocardiographic parameters were recorded at baseline and at 
      follow-up. RESULTS: The patients' mean age was 76 years and 65% were male. 
      Coronary artery disease was present in 85% and 45% ent in had previous bypass 
      surgery. Renal failure was present in 65%, atrial fibrillation in 60%, and 30% 
      had an implantable cardioverter defibrillator/cardiac resynchronization therapy 
      device. Mean left ventricular ejection fraction was 36%. Grade III-IV MR was 
      present in all patients with the vast majority suffering from functional MR 
      secondary to ventricular remodeling. New York Heart Association (NYHA) class was 
      III-IV in 90%. Patients were followed for a mean of 231 days. Acute reduction of 
      MR grade to < or = 2 was accomplished in 19 of the 20 patients (95%) with a 30 
      day mortality of 5%. At follow-up MR was reduced to < or = 2 in 64% of patients, 
      and NYHA class improved in 70% of patients. An additional 2 patients (11%) died 
      during follow-up. CONCLUSIONS: MitraClip implantation is feasible and safe in 
      high risk highly symptomatic patients with significant MR. Acute and mid-term 
      results are comparable to similar high risk patient cohorts in the literature. 
      Continued surveillance and longer follow-up are needed to elucidate which 
      patients are most likely to benefit from the procedure.
FAU - Koifman, Edward
AU  - Koifman E
FAU - Fefer, Paul
AU  - Fefer P
FAU - Hay, Ilan
AU  - Hay I
FAU - Feinberg, Micha
AU  - Feinberg M
FAU - Maor, Elad
AU  - Maor E
FAU - Guetta, Victor
AU  - Guetta V
LA  - eng
PT  - Journal Article
PL  - Israel
TA  - Isr Med Assoc J
JT  - The Israel Medical Association journal : IMAJ
JID - 100930740
SB  - IM
MH  - Aged
MH  - Feasibility Studies
MH  - Female
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/adverse 
      effects/instrumentation/methods/mortality
MH  - Humans
MH  - Israel/epidemiology
MH  - Male
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - *Mitral Valve Annuloplasty/adverse effects/instrumentation/methods/mortality
MH  - Mitral Valve Insufficiency/diagnosis/physiopathology/*surgery
MH  - Outcome Assessment, Health Care
MH  - Prosthesis Design
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Survival Analysis
MH  - Ultrasonography
EDAT- 2014/03/22 06:00
MHDA- 2014/04/08 06:00
CRDT- 2014/03/21 06:00
PHST- 2014/03/21 06:00 [entrez]
PHST- 2014/03/22 06:00 [pubmed]
PHST- 2014/04/08 06:00 [medline]
PST - ppublish
SO  - Isr Med Assoc J. 2014 Feb;16(2):91-5.