, Volume 101, Issue 1, pp 69-71
Date: 19 Nov 2011

Rapid pacing facilitates grasping and MitraClip implantation in severe mitral leaflet prolapse

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Sirs:

Surgery is the current gold standard of treatment for patients with symptomatic severe mitral valve regurgitation (MR) or asymptomatic severe MR with evidence of left ventricular dysfunction or dilatation, as it represents the only approach with defined clinical success, providing sustained relief of symptoms for heart failure. However, it has been shown in a recent survey that a large proportion of older patients with high comorbidity index were denied surgery [1]. A possible treatment option for this high-risk group is the recently developed percutaneous edge-to-edge repair approach with the MitraClip (MitraClip®-System, Abbott, USA). The results of the EVEREST II trial have shown that the procedure is safe and associated with improvements in clinical outcome [2, 3].

Given that certain leaflet anatomy complicates proper grasping with sufficient reduction in MR, echocardiographic criteria play a crucial role among clinical considerations for patient selection [4]. Commonly accepte ...