, Volume 101, Issue 12, pp 1013-1015
Date: 12 Jun 2012

Percutaneous edge-to-edge mitral valve repair for recurrent mitral regurgitation after percutaneous mitral annuloplasty: towards a staged approach

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Sirs:

Although mitral valve (MV) repair remains the treatment of choice to treat severe mitral valve regurgitation (MR), there is still a plethora of patients that, in light of their complex comorbid profile, could be approached in a less invasive fashion [1]. Timely echocardiography evaluation of the valve anatomy and the regurgitation flow-dynamics are crucial to plan an adequate percutaneous repair strategy [2, 3]. In this context, the MR often results from an annular dilatation that leads to a decreased MV leaflets coaptation.

The percutaneous transvenous MitraClip®-System (MitraClip, Abbot, USA) has been recently introduced and popularized to mimic the “edge to edge” MV repair firstly described by Alfieri et al. The results of the EVEREST II trial have demonstrated that the procedure is safe and associated with improvements in clinical outcomes [4].

Implantation of a percutaneous transvenous mitral annuloplasty (PTMA) device to reduce the MV annular size has also been shown to be fea ...