1000 MitraClip™ procedures

Mitral regurgitation (MR) is the most common valve pathology affecting almost 10% of individuals above 75 years and is associated with decreased mid- and long-term survival rates.1,2 In 1991, the concept of repairing MR by suturing the free edges of the anterior and posterior mitral leaflets at the origin of the pathology thus creating a double orifice was invented by Alfieri et al.3 This technique provided feasibility and high procedural success rates and subsequently inspired the development of a catheter-based percutaneous approach mimicking the Alfieri stich. The MitraClip™ system (Abbott Medical, Menlo Park, CA, USA) is used to implant a Dacron-covered, two-armed clip with a steerable guiding catheter to reduce the severity of MR. After insertion via the femoral vein and transseptal access, the clip is positioned over the maximum MR area on the atrial side of the mitral valve and aligned perpendicular to the line of coaptation guided by fluoroscopy and transoesophageal echo imaging. After advancing into the left ventricle, corresponding segments of the anterior and posterior mitral leaflets are grasped on retraction. The initial result should be evaluated carefully and verified before re-positioning or clip deployment. MitraClip™ procedures can be performed with a comparable safety profile under general anaesthesia or under deep sedation.4