Key result
MitraClip provides less invasive TEER for high-risk severe MR requiring careful patient selection.
Why the study?
Two major prospective randomized controlled trials investigating the clinical advantage of the MitraClip system over optimal medical therapy in severe mitral regurgitation showed controversial conclusions, prompting reconsideration of optimal patient selection and therapeutic strategy.
Does percutaneous edge-to-edge mitral valve repair (MitraClip) improve outcomes in high-risk patients with severe mitral regurgitation?
Does percutaneous edge-to-edge mitral valve repair (MitraClip) improve outcomes in high-risk patients with severe mitral regurgitation?
This review highlights that while MitraClip is established for high-risk degenerative MR, its application in functional MR requires careful patient selection, balancing MR severity against the degree of left ventricular dysfunction.
Requires careful selection for MitraClip in high-risk severe MR; leaves open optimal criteria in functional MR.
Patients with advanced heart failure often accompany severe function mitral regurgitation refractory to optimal medical therapy. Degenerative mitral regurgitation also develops due to various degeneration of mitral valve. Surgical intervention to the mitral valve might be effective in some cases, but it is challenging for the high-risk cases. Recently, percutaneous edge-to-edge mitral valve repair using the MitraClip system, which enables us to approach the mitral valve at relatively low risk, has developed. Two major prospective randomized control trials have been conducted to investigate the clinical advantage of MitraClip system over optimal medical therapy in patients with severe mitral regurgitation; both showed controversial conclusions. Now is a time to consider optimal patient selection and therapeutic strategy using MitraClip system.
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Ueno et al. (2020) conducted a review in Mitral regurgitation. MitraClip vs. Medical therapy or surgical intervention was evaluated. MitraClip provides a less invasive transcatheter edge-to-edge repair option for high-risk patients with severe mitral regurgitation, requiring careful patient selection based on left ventricular function and regurgitation severity.
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