Mitral regurgitation (MR) is a frequent valvulopathy and when the optimal medical treatment at maximum tolerated doses is not enough, surgery is the first course of action. And even though edge-to-edge repair with clips has seen substantial improvement, it is currently reserved for those at high risk of surgery. However, there is an increasing number...
TCT 2023 | CLASP IID Study 1-Year Results: PASCAL vs. MITRACLIP for Degenerative Mitral Regurgitation
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,...
Degenerative Mitral Regurgitation: Impact on Post-Procedural Gradient
Primary or degenerative mitral regurgitation (MR) occurs frequently. Even though surgery continues to be the standard treatment at present, it remains risky for one group of patients, which makes edge-to-edge mitral valve repair (MV-TEER) a viable alternative. We are well aware that moderate to severe MR is associated with worse prognosis. However, post procedural mean...
MitraScore: What Does the Final Result of Edge-to-Edge Treatment of Mitral Regurgitation Provide?
Edge-to-edge treatment has proven to be a safe and effective technique in follow-up, decreasing mortality and hospitalizations for heart failure when a good result is achieved. The MitraScore was developed to assess the outcome at the end of the procedure. In that sense, results <3 represent mild mitral regurgitation, which would be related to lower...
ACC 2023 | COAPT Study: 5 Year Followup after Transcatheter Repair of Secondary Mitral Regurgitation
The five year outcomes of the multicenter open label COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) were presented at ACC 2023; it included 614 patients with cardiac failure (CF) and moderate to severe (3+/4+) symptomatic secondary mitral regurgitation, despite medical therapy. Patients were randomized 1:1...
Secondary Mitral Regurgitation: Stages of Heart Failure and Prognostic Implications after Transcatheter Edge-to-Edge Repair
We are already familiar with the strong impact of secondary mitral valve regurgitation (SMR) in survival and quality of life. Most of these patients present heart failure (HF) with reduced ejection fraction (HFrEF). Stages of heart failure based on extra-mitral cardiac involvement has been shown relevant. There is also extensive research on aortic valve disease...
Severe Mitral Regurgitation and Cardiogenic Shock: Is Edge-to-Edge a Valid Strategy?
At present, cardiogenic shock continues to present high mortality despite the new treatments and ventricular assistance devices available in some centers. In this group, the presence of severe mitral regurgitation (MR) is around 5% and, on many occasions, it cannot be treated with surgery because of hemodynamic conditions. Edge-to-edge repair has been looked at by...
TCT 2022 | CLASP II D TRIAL: Transcatheter Edge-to-Edge Repair for Mitral Regurgitation in Patients at Prohibitive Risk
The CLASP IID study was a prospective randomized study to assess the efficacy and effectiveness of the PASCAL transcatheter valve repair system compared with the MitraClip device for patients with degenerative mitral regurgitation (MR) at prohibitive surgical risk. The study included Patients at prohibitive surgical risk, candidates for both devices, with MR 3+ to 4+,...
Is the Cause of Mitral Regurgitation Relevant for MitraClip?
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...
SOLACI-SOCIME 2022 | When is indicated the transcatheter treatment of mitral regurgitation
Read the most outstanding articles from the first day of the SOLACI-SOCIME 2022 Congress. In this case, consult the presentation by Dr. Márcio Montenegro, entitled “When is indicated the transcatheter treatment of mitral regurgitation”