Skip to main content
SpringerLink
Log in

Percutaneous Treatment in Mitral Valve Regurgitation

  • Chapter
  • First Online:
Secondary Mitral Valve Regurgitation

  • 1039 Accesses

Abstract

Percutaneous mitral valve intervention (PMVI) has become an alternative therapeutic option for patients who are not eligible for conventional surgical treatment of mitral regurgitation (MR). PMVI can correct MR by means of the direct or indirect reduction of mitral annular dilatation, or through intervention on the primary or secondary abnormalities of the mitral apparatus. Among PMVI techniques, the MitraClip system, which is able to reproduce the edge-to-edge surgical procedure, is the only percutaneous therapeutic approach that can presently be considered clinically validated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Mirabel M, Iung B, Baron G, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery? Eur Heart J. 2007;28:1358–65.

    Article  PubMed  Google Scholar 

  2. Bursi F, Enriquez-Sarano M, Nkomo VT, et al. Heart failure and death after myocardial infarction in the community: the emerging role of mitral regurgitation. Circulation. 2005;111:295–301.

    Article  PubMed  Google Scholar 

  3. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368:1005–11.

    Article  PubMed  Google Scholar 

  4. Ling LH, EnriquezSarano M, Seward JB, et al. Clinical outcome of mitral regurgitation due to flail leaflet. N Engl J Med. 1996;335:1417–23.

    Article  CAS  PubMed  Google Scholar 

  5. Avierinos JF, Gersh BJ, Melton 3rd LJ, et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation. 2002;106:1355–61.

    Article  PubMed  Google Scholar 

  6. Grigioni F, Enriquez-Sarano M, Zehr KJ, Bailey KR, Tajik AJ. Ischemic mitral regurgitation: long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation. 2001;103:1759–64.

    Article  CAS  PubMed  Google Scholar 

  7. Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2006;48:e1–148.

    Article  PubMed  Google Scholar 

  8. Vahanian A, Iung B. The new ESC/EACTS Guidelines on the management of valvular heart disease. Arch Cardiovasc Dis. 2012;105:465–7.

    Article  PubMed  Google Scholar 

  9. Mirabel M, Lung B, Messika-Zeitoun D, et al. Severe, symptomatic, mitral regurgitation in the elderly: how many patients are denied surgery and what are their characteristics? J Am Coll Cardiol. 2007;49:300a.

    Google Scholar 

  10. Fucci C, Sandrelli L, Pardini A, Torracca L, Ferrari M, Alfieri O. Improved results with mitral valve repair using new surgical techniques. Eur J Cardiothorac Surg. 1995;9:621–6; discussion 626–7.

    Article  CAS  PubMed  Google Scholar 

  11. Alfieri O, Maisano F, De Bonis M, et al. The double-orifice technique in mitral valve repair: a simple solution for complex problems. J Thorac Cardiovasc Surg. 2001;122:674–81.

    Article  CAS  PubMed  Google Scholar 

  12. Bhudia SK, McCarthy PM, Smedira NG, Lam BK, Rajeswaran J, Blackstone EH. Edge-to-edge (Alfieri) mitral repair: results in diverse clinical settings. Ann Thorac Surg. 2004;77:1598–606.

    Article  PubMed  Google Scholar 

  13. Maisano F, Torracca L, Oppizzi M, et al. The edge-to-edge technique: a simplified method to correct mitral insufficiency. Eur J Cardiothorac Surg. 1998;13:240–5; discussion 245–6.

    Article  CAS  PubMed  Google Scholar 

  14. 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;54:686–94.

    Article  PubMed  Google Scholar 

  15. Luk A, Butany J, Ahn E, et al. Mitral repair with the Evalve MitraClip device: histopathologic findings in the porcine model. Cardiovasc Pathol. 2009;18:279–85.

    Article  PubMed  Google Scholar 

  16. Mauri L, Garg P, Massaro JM, et al. The EVEREST II Trial: design and rationale for a randomized study of the evalve mitraclip system compared with mitral valve surgery for mitral regurgitation. Am Heart J. 2010;160:23–9.

    Article  PubMed  Google Scholar 

  17. Silvestry FE, Rodriguez LL, Herrmann HC, et al. Echocardiographic guidance and assessment of percutaneous repair for mitral regurgitation with the Evalve MitraClip: lessons learned from EVEREST I. J Am Soc Echocardiogr. 2007;20:1131–40.

    Article  PubMed  Google Scholar 

  18. Gillinov AM, Cosgrove DM, Blackstone EH, et al. Durability of mitral valve repair for degenerative disease. J Thorac Cardiovasc Surg. 1998;116:734–43.

    Article  CAS  PubMed  Google Scholar 

  19. De Bonis M, Lapenna E, La Canna G, et al. Mitral valve repair for functional mitral regurgitation in end-stage dilated cardiomyopathy: role of the“ edge-to-edge” technique. Circulation. 2005;112.

    Google Scholar 

  20. Maisano F, Caldarola A, Blasio A, De Bonis M, La Canna G, Alfieri O. Midterm results of edge-to-edge mitral valve repair without annuloplasty. J Thorac Cardiovasc Surg. 2003;126:1987–97.

    Article  PubMed  Google Scholar 

  21. Alfieri O, Lorusso R. The double-orifice technique for mitral valve reconstruction: predictors of postoperative outcome – conference discussion. Eur J Cardiothorac Surg. 2001;20:589.

    Google Scholar 

  22. Maisano F, Schreuder JJ, Oppizzi R, Fiorani B, Fino C, Alfieri O. The double-orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: surgical technique. Eur J Cardiothorac Surg. 2000;17:201–5.

    Article  CAS  PubMed  Google Scholar 

  23. Condado JA, Acquatella H, Rodriguez L, Whitlow P, Velez-Gimo M, St Goar FG. Percutaneous edge-to-edge mitral valve repair: 2-year follow-up in the first human case. Catheter Cardiovasc Interv. 2006;67:323–5.

    Article  PubMed  Google Scholar 

  24. Argenziano M, Skipper E, Heimansohn D, et al. Surgical revision after percutaneous mitral repair with the MitraClip device. Ann Thorac Surg. 2010;89:72–80.

    Article  PubMed  Google Scholar 

  25. Feldman T, Foster E, Glower DD, et al. Percutaneous repair or surgery for mitral regurgitation. N Engl J Med. 2011;364:1395–406.

    Article  CAS  PubMed  Google Scholar 

  26. Feldman T, Wasserman HS, Herrmann HC, et al. Percutaneous mitral valve repair using the edge-to-edge technique: six-month results of the EVEREST phase I clinical trial. J Am Coll Cardiol. 2005;46:2134–40.

    Article  PubMed  Google Scholar 

  27. George JC, Varghese V, Dangas G, Feldman TE. Percutaneous mitral valve repair: lessons from the EVEREST II (Endovascular Valve Edge-to-Edge REpair Study) and beyond. JACC Cardiovasc Interv. 2011;4:825–7.

    Article  PubMed  Google Scholar 

  28. Glower D, Ailawadi G, Argenziano M, et al. EVEREST II randomized clinical trial: predictors of mitral valve replacement in de novo surgery or after the MitraClip procedure. J Thorac Cardiovasc Surg. 2012;143:S60–3.

    Article  PubMed  Google Scholar 

  29. Goldberg SL, Feldman T. Percutaneous mitral valve interventions: overview of new approaches. Curr Cardiol Rep. 2010;12:404–12.

    Article  PubMed  Google Scholar 

  30. Herrmann HC, Gertz ZM, Silvestry FE, et al. Effects of atrial fibrillation on treatment of mitral regurgitation in the EVEREST II (Endovascular Valve Edge-to-Edge Repair Study) randomized trial. J Am Coll Cardiol. 2012;59:1312–9.

    Article  PubMed  Google Scholar 

  31. Herrmann HC, Kar S, Siegel R, et al. Effect of percutaneous mitral repair with the MitraClip (R) device on mitral valve area and gradient. EuroIntervention. 2009;4:437–42.

    Article  PubMed  Google Scholar 

  32. Herrmann HC, Rohatgi S, Wasserman HS, et al. Mitral valve hemodynamic effects of percutaneous edge-to-edge repair with the MitraClip (TM) device for mitral regurgitation. Catheter Cardiovasc Interv. 2006;68:821–8.

    Article  PubMed  Google Scholar 

  33. Ladich E, Michaels MB, Jones RM, et al. Pathological healing response of explanted MitraClip devices. Circulation. 2011;123:1418–27.

    Article  CAS  PubMed  Google Scholar 

  34. Siegel RJ, Biner S, Rafique AM, et al. The acute hemodynamic effects of MitraClip therapy. J Am Coll Cardiol. 2011;57:1658–65.

    Article  PubMed  Google Scholar 

  35. Whitlow PL, Feldman T, Pedersen WR, et al. Acute and 12-month results with catheter-based mitral valve leaflet repair: the EVEREST II (Endovascular Valve Edge-to-Edge Repair) High Risk Study. J Am Coll Cardiol. 2012;59:130–9.

    Article  PubMed  Google Scholar 

  36. Turi ZG, Rosenbloom M. An option for the high-comorbidity patient with mitral regurgitation. J Am Coll Cardiol. 2012;59:140–2.

    Article  PubMed  Google Scholar 

  37. Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2012;42:S1–44.

    Article  PubMed  Google Scholar 

  38. McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33:1787–847.

    Article  PubMed  Google Scholar 

  39. Ciarka A, Braun J, Delgado V, et al. Predictors of mitral regurgitation recurrence in patients with heart failure undergoing mitral valve annuloplasty. Am J Cardiol. 2010;106:395–401.

    Article  PubMed  Google Scholar 

  40. Bothe W, Kvitting JP, Swanson JC, et al. How do annuloplasty rings affect mitral leaflet dynamic motion? Eur J Cardiothorac Surg. 2010;38:340–9.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Timek TA, Nielsen SL, Lai DT, et al. Edge-to-edge mitral valve repair without ring annuloplasty for acute ischemic mitral regurgitation. Circulation. 2003;108:122–7.

    Article  Google Scholar 

  42. De Bonis M, Lapenna E, La Canna G, et al. Mitral valve repair for functional mitral regurgitation in end-stage dilated cardiomyopathy – role of the “edge-to-edge” technique. Circulation. 2005;112:I402–8.

    PubMed  Google Scholar 

  43. Harnek J, Webb JG, Kuck KH, et al. Transcatheter implantation of the MONARC coronary sinus device for mitral regurgitation: 1-year results from the EVOLUTION phase I study (Clinical Evaluation of the Edwards Lifesciences Percutaneous Mitral Annuloplasty System for the Treatment of Mitral Regurgitation). JACC Cardiovasc Interv. 2011;4:115–22.

    Article  PubMed  Google Scholar 

  44. Siminiak T, Wu JC, Haude M, et al. Treatment of functional mitral regurgitation by percutaneous annuloplasty: results of the TITAN Trial. Eur J Heart Fail. 2012;14:931–8.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Machaalany J, Bilodeau L, Hoffmann R, et al. Treatment of functional mitral valve regurgitation with the permanent percutaneous transvenous mitral annuloplasty system: results of the multicenter international Percutaneous Transvenous Mitral Annuloplasty System to Reduce Mitral Valve Regurgitation in Patients with Heart Failure trial. Am Heart J. 2013;165:761–9.

    Article  PubMed  Google Scholar 

  46. Maselli D, Guarracino F, Chiaramonti F, Mangia F, Borelli G, Minzioni G. Percutaneous mitral annuloplasty: an anatomic study of human coronary sinus and its relation with mitral valve annulus and coronary arteries. Circulation. 2006;114:377–80.

    Article  PubMed  Google Scholar 

  47. Descoutures F, Himbert D, Maisano F, et al. Transcatheter valve-in-ring implantation after failure of surgical mitral repair. Eur J Cardiothorac Surg. 2013;44:e8–15.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Heart Surgery Department, San Raffeale Hospital, Via Olgettina, 60, Milan, 20100, Italy

    Paolo Denti & Alfieri Ottavio

Authors
  1. Paolo Denti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alfieri Ottavio
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paolo Denti .

Editor information

Editors and Affiliations

  1. GVM Care and Research Group, University of Palermo, Palermo, Italy

    Khalil Fattouch

  2. CHU Sart Tilman, University of Liège, Liège, Belgium

    Patrizio Lancellotti

  3. Hammersmith Hospital, Imperial College of London, London, United Kingdom

    Gianni D. Angelini

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Denti, P., Ottavio, A. (2015). Percutaneous Treatment in Mitral Valve Regurgitation. In: Fattouch, K., Lancellotti, P., Angelini, G. (eds) Secondary Mitral Valve Regurgitation. Springer, London. https://doi.org/10.1007/978-1-4471-6488-3_17

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6488-3_17

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6487-6

  • Online ISBN: 978-1-4471-6488-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation