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…
1000 MitraClips: Results from the World’s Most Experienced Site
In September 2008, interventional physicians at the Heart and Vascular Centre Hamburg conducted the first MitraClip implantation after its Conformité Européenne (CE)-marking approval. In July 2019, the same site reached an amazing milestone, 1000 MitraClips implanted, and in doing so it became the most experienced site in the world. Those 1000 patients treated had an average logistic…
TCT 2019 | PARTNER 2A at 5 Years: In Intermediate-Risk Patients, TAVR Is Still Head-to-Head with Surgery
Courtesy of the SBHCI. The 2-year results of the PARTNER 2A trial showed that transcatheter aortic valve implantation has a result similar to that of surgery in patients with aortic stenosis and intermediate surgical risk. We lacked long-term data, both clinical and related to prosthesis function. Now, at TCT 2019, researchers presented the 5-year data for this…
TCT 2019 | Mitral Valve-in-Valve: 1-Year Results for Sapien 3 in Mitral Valve Replacement for Degenerated Bioprostheses
Courtesy of SBHCI. The aim of this work was to assess the contemporary outcomes of mitral valve-in-valve using Sapien 3 prostheses, see the differences between trasapical and transseptal access, and establish 1-year mortality predictors. Researchers analyzed retrospectively the data from the Society of Thoracic Surgeons [STS]/American College of Cardiology TVT Registry, which included 1576 patients who had…
MitraClip in the Real World: Mid-Term Progress
Courtesy of Dr. Carlos Fava. The fact that the outcomes of edge-to-edge repair with MitraClip have improved, particularly in the immediate and short term, is widely known. Such improvement is basically a result of more operator experience and the arrival of 3-D echocardiography. However, there are no mid-term follow-up studies available, except for the EVEREST…
ESC 2019 | MITRA-FR: 2-Year Outcomes of One of the Largest Studies on MitraClip
Negative one-year outcomes of Mitra-FR led to several discussions and hypothesis, especially after the COAPT was published only a few weeks later. According to the COAPT study, the MitraClip was able to reduce hospitalization rate for cardiac failure and also all-cause mortality, compared against optimal medical treatment alone. When comparing the COAPT to the Mitra-FR,…
Can We Treat Severe Residual Mitral Regurgitation after MitraClip without Surgery?
Courtesy of Dr. Carlos Fava. Edge to edge with MitraClip was shown effective and safe, and its outcomes have been improving over these past few years. However, one of its greatest challenges involves not being able to reduce mitral regurgitation (MR) after device implantation, resulting in the need for surgery, as some studies have shown…
New Promising Alternatives for Mitral Regurgitation
PASCAL transcatheter valve repair system for mitral regurgitation has shown feasibility and safety to treat patients with grade 3+ or 4+, regardless etiology. Regurgitation grade was significantly reduced, and this was accompanied by clinical improvement in functional class, exercise capacity and quality of life. This study soon to be published in J Am Coll Cardiol…
EuroPCR 2019 | COAPT: Mitral Valve Reduction is Associated to Lower Hospitalization and Death
This new analysis shows the mechanism behind the benefit of using MitraClip and the necessary degree of residual mitral regurgitation (MR) to have an impact. Regardless the intervention type, patients with cardiac failure and secondary mitral regurgitation present lower hospitalization for cardiac failure, all-cause mortality and improved quality of life the lower the MR. MitraClip…
MitraClip in the “Real World”
Courtesy of Dr. Carlos Fava. Mitral regurgitation (MR) is the most frequent valvulopathy in Europe and US, affecting close to 10% of patients over 75, with more morbidity and mortality. The treatment of choice is percutaneous repair instead of replacement, to maintain the sub-valvular apparatus that contributes to systole. This is feasible and has better…
The Significance of Aetiology on Mitral Regurgitation
Courtesy of Dr. Carlos Fava. The aetiology of mitral regurgitation (MR) may be divided into primary, organic or degenerative MR, and secondary or functional MR. These two present different physiopathology. The treatment strategy is different for each, and edge-to-edge treatment with Mitraclip is currently emerging as a valid alternative for high-risk patients. This study analyzed 943 patients…