PMID- 26309842
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150827
LR  - 20200930
IS  - 2225-319X (Print)
IS  - 2304-1021 (Electronic)
IS  - 2225-319X (Linking)
VI  - 4
IP  - 4
DP  - 2015 Jul
TI  - Current state of transcatheter mitral valve repair with the MitraClip.
PG  - 335-40
LID - 10.3978/j.issn.2225-319X.2015.02.02 [doi]
AB  - BACKGROUND: Many patients affected with mitral valve regurgitation suffer from 
      multiple comorbidities. The MitraClip device provides a safe means of 
      transcatheter valve repair in patients with suitable mitral valve anatomy who are 
      at prohibitive risk for surgery. We describe our early procedural outcomes and 
      present a summary of the current state of MitraClip technology in the United 
      States. METHODS: We performed a retrospective chart review of initial high-risk 
      or inoperable patients who underwent MitraClip placement at our institution after 
      completion of the EVEREST II study. We examined the primary outcome of 30-day 
      mortality, and secondary outcomes included extent of reduction of mitral 
      regurgitation (MR), New York Heart Association (NYHA) functional class 
      improvement, length of stay, and major complications. RESULTS: A total of 115 
      high-risk patients (mean Society of Thoracic Surgeons predicted risk of mortality 
      9.4%+/-6.1%) underwent the MitraClip procedure at our institution between March 
      2009 and April 2014. Co-morbidities including coronary artery disease (67.8%), 
      pulmonary disease (39.1%) and previous cardiac surgery (44.3%) were common. The 
      device was placed successfully in all patients with a 30-day mortality of 2.6%. 
      All patients demonstrated 3+ or 4+ MR on preoperative imaging, and 80.7% of 
      patients had trace or 1+ MR at hospital discharge. NYHA class improved 
      substantially, with 79% of patients exhibiting class III or IV symptoms 
      pre-procedure and 81% reporting class I or II symptoms at one month follow-up. 
      CONCLUSIONS: The MitraClip procedure provides a safe alternative to surgical or 
      medical management for high-risk patients with MR and suitable valve anatomy. A 
      comprehensive heart team approach is essential, with surgeons providing critical 
      assessment of patient suitability for surgery versus percutaneous therapy as well 
      as performance of the valve procedure.
FAU - Downs, Emily A
AU  - Downs EA
AD  - 1 Department of Surgery, Division of Thoracic and Cardiovascular Surgery, 2 
      Department of Medicine, Division of Cardiovascular Medicine, University of 
      Virginia, Virginia, USA.
FAU - Lim, D Scott
AU  - Lim DS
AD  - 1 Department of Surgery, Division of Thoracic and Cardiovascular Surgery, 2 
      Department of Medicine, Division of Cardiovascular Medicine, University of 
      Virginia, Virginia, USA.
FAU - Saji, Mike
AU  - Saji M
AD  - 1 Department of Surgery, Division of Thoracic and Cardiovascular Surgery, 2 
      Department of Medicine, Division of Cardiovascular Medicine, University of 
      Virginia, Virginia, USA.
FAU - Ailawadi, Gorav
AU  - Ailawadi G
AD  - 1 Department of Surgery, Division of Thoracic and Cardiovascular Surgery, 2 
      Department of Medicine, Division of Cardiovascular Medicine, University of 
      Virginia, Virginia, USA.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Cardiothorac Surg
JT  - Annals of cardiothoracic surgery
JID - 101605877
PMC - PMC4526504
OTO - NOTNLM
OT  - Mitral regurgitation (MR)
OT  - cardiac catheterization/intervention
OT  - percutaneous
EDAT- 2015/08/27 06:00
MHDA- 2015/08/27 06:01
PMCR- 2015/07/01
CRDT- 2015/08/27 06:00
PHST- 2015/01/03 00:00 [received]
PHST- 2015/01/18 00:00 [accepted]
PHST- 2015/08/27 06:00 [entrez]
PHST- 2015/08/27 06:00 [pubmed]
PHST- 2015/08/27 06:01 [medline]
PHST- 2015/07/01 00:00 [pmc-release]
AID - acs-04-04-335 [pii]
AID - 10.3978/j.issn.2225-319X.2015.02.02 [doi]
PST - ppublish
SO  - Ann Cardiothorac Surg. 2015 Jul;4(4):335-40. doi: 
      10.3978/j.issn.2225-319X.2015.02.02.