The negative impact of mitral regurgitation (MR) on patient mortality, morbidity, and quality of life is widely recognized. However, only 15% of patients are referred for surgery due to their high surgical risk and low ejection fraction. Transcatheter edge-to-edge repair has become an important alternative for this group of patients. For subjects with degenerative MR,...
Mitral regurgitation (MR) is the most common valvulopathy and full medical treatment at maximal tolerated doses has been shown quite effective to treat it. However, its limited in a group of patients that require valve intervention. At present, the ideal treatment is surgical valve replacement, which is in many cases is not viable because of...
Mitral regurgitation (MR) is the most frequent type of valve heart disease, and the COAPT has shown that edge-to-edge with guideline directed medical treatment (GDMT) at maximal tolerated dose (MTD) is superior to medical treatment alone. However, we did not have a score to predict patient evolution when treated with this strategy. Researchers analyzed the...
Mitral regurgitation (MR) is the most common valvulopathy: it is present in (at least) 7.5% of patients >75 years old. This pathology can be classified as primary or degenerative MR (DMR) and secondary or functional MR (FMR). FMR can be caused by dilatation of the left atrium (most often due to atrial fibrillation), occurring in...
Chronic obstructive pulmonary disease (COPD) and cardiovascular disease are associated to hospitalization and mortality. When associated to severe mitral regurgitation, not only do these two conditions have poor evolution, but they also limit the possibility of surgical valve replacement, given its high risk. Edge-to-edge repair with MitraClip has been shown beneficial in a group of...
The EVEREST II trial has shown the MitraClip has similar mortality rate to that of surgery and, on the other hand, we are well aware that residual mitral regurgitation (MR) is associated with a strong negative impact. However, research has shown little about transvalvular gradient after MitraClip and what it entails. 268 patients receiving MitraClip were...
Severe mitral regurgitation is associated to cardiac failure and hospitalization and over time is accompanied by kidney failure, which leads to higher mortality. In the COAPT study, in patients with low ejection fraction, MitraClip showed benefits over medical treatment, but there was an important group of people with kidney function deterioration. The evolution and benefit...
Transcatheter mitral valve repair using the edge-to-edge strategy has become a therapeutic alternative for patients with severe primary mitral valve regurgitation (MVG) who are at high or extreme surgical risk. However, both degree of residual regurgitation and gradient after the procedure should be taken into account, as in previous studies the latter was associated with...
Currently, edge-to-edge therapy with MitraClip has demonstrated efficacy and safety for the treatment of patients with degenerative or functional mitral regurgitation who are at high risk for surgery. However, device-related complications are still present—though their frequency is subsiding due to greater experience, 3D doppler echocardiography development, and technological advancements: loss of leaflet insertion (LLI), single...
Courtesy of Dr. Carlos Fava. The MitraClip has been shown to benefit a certain group of patients and it is a well-known fact that a ≥5 mmHg is associated to a more torpid evolution. However, there is little evidence when it comes to venous pulmonary waves, changes in left atrial pressure and V wave. 121...