Abstract
As a large portion of the US demographic advances into the later decades of life, the incidence of valvular heart disease is expected to increase. Mitral regurgitation (MR) caused by primary valve abnormality (degenerative) or secondary to cardiomyopathy (functional) is an important cause of heart failure. Management of valvular heart disease is expected to account for a large segment of services provided to heart failure patients. Recent years have seen a transition from surgical therapy to minimally invasive techniques, specifically percutaneous approaches for the correction of heart valve disease. The double orifice technique of mitral valve repair using the MitraClip™ System (Abbott Vascular, Menlo Park, CA) is one of many percutaneous approaches to treat significant MR. This technique is effective in patients with both degenerative and functional MR, reducing MR severity and improving heart failure symptoms. Broad acceptance of this percutaneous technology requires collaboration among cardiologists and cardiac surgeons in centers with superior catheter experience and knowledge of echocardiography.
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Papers of particular interest, published recently, have been highlighted as: • Of importance
Fedak PW, McCarthy PM, Bonow RO: Evolving concepts and technologies in mitral valve repair. Circulation 2008, 117:963–974.
Kar S, Feldman T, Goar F: Mitral valve repair using the MitraClip: from concept to reality. Cardiac Interventions Today 2008, 2:39–45.
• Feldman T, Glower D: Patient selection for percutaneous mitral valve repair: insight from early clinical trial applications. Nat Clin Pract Cardiovasc Med 2008, 5:84–90. This review of the American College of Cardiology/American Heart Association practice guidelines for mitral valve repair offers recommendations regarding patient selection for various percutaneous device therapies.
Alfieri O, Maisano F, De Bonis M, et al.: The double-orifice technique in mitral valve repair. A simple solution for complex problem. J Thorac Cardiovasc Surg 2001, 122:674–681.
Gillinov AM., Liddicoat JR: Percutaneous mitral valve repair. Sem Thorac Cardiovasc Surg 2006, 18:115–121.
Feldman T, Wasserman HS, Herrmann HC, et al.: Percutaneous mitral valve repair using the edge-to-edge technique. J Am Coll Cardiol 2005, 46:2134–2140.
• Feldman T, Kar S, Rinaldi M, et al.: Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort. J Am Coll Cardiol 2009, 54:686–694. This study reports on the safety and midterm durability results of the 107 initial EVEREST cohort patients at 1, 2, and 3 years after procedure. The article highlights the most current findings from the prospective multicenter single-arm study to evaluate the feasibility, safety, and efficacy of the MitraClip system.
• Feldman T, Kar S: Percutaneous mitral valve repair techniques: surgical concepts adapted to catheter-based approaches. Indian Heart J 2008, 60:507–513. This article reviews various novel approaches to mitral valve repair. It includes a discussion on percutaneous mitral annuloplasty devices, as well as chamber and annular remodeling devices not covered in this manuscript.
Kar S: EVEREST II high-risk registry data. Presented at the EuroPCR 2009 Symposium. Barcelona, Spain; May 19–22, 2009.
Rosengart TK, Feldman T, Borger MA, et al.: Percutaneous and minimally invasive valve procedures: a scientific statement from the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2008, 117:1750–1767.
• Hermann HC, Kar S, Siegel R: Effect of percutaneous mitral repair with the MitraClip device on mitral valve area and gradient. Euro Intervention 2009, 4:437–442. This article discusses a study of 96 patients treated with the MitraClip device and reports the 24-month follow-up echocardiogram data. Mitral valve area and mean transmitral gradient was measured to assess the potential for clinically significant left ventricular inflow obstruction after percutaneous repair.
Mack MJ: Percutaneous mitral valve repair: a fertile field of innovative treatment strategies. Circulation 2006, 113:2269–2271.
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Hussaini, A., Kar, S. Percutaneous Mitral Valve Repair: Potential in Heart Failure Management. Curr Heart Fail Rep 7, 22–26 (2010). https://doi.org/10.1007/s11897-010-0006-8
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DOI: https://doi.org/10.1007/s11897-010-0006-8