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…
Is Tricuspid Regurgitation after TAVR Significant?
Courtesy of Dr. Carlos Fava. Severe or moderate mitral regurgitation is associated to worse evolution after TAVR. However, we should not forget the tricuspid valve that, even though not extensively researched, is also associated to a negative impact in its evolution. A meta-analysis of 12 studies with a total 41485 patients was carried out. …
Mitral Valve Repair with MirtaClip Was Feasible and Safe
Transcatheter mitral valve repair (TMVR) with MitraClip was shown feasible and safe, and therefore a viable option for symptomatic patients with severe mitral valve regurgitation of prohibitive risk. In this regard, the procedure alleviates symptoms, cardiac regurgitation and has a potential benefit on ventricular remodeling. However, many patients presented atrial fibrillation (AF) and mitral valve…
Good Outcomes for MitraClip “Off Label”
Courtesy of Dr. Carlos Fava. Mitral regurgitation is the most frequent type of valve disease, accounting for >6% of patients over 65 years old. Surgery is currently the strategy of choice, but percutaneous treatment is a valid alternative. The long-term progress of symptomatic patients at high surgical risk who do not meet the formal indications for…
Continuous Monitoring of Left Atrial Pressure during MitraClip, Regardless Echocardiography
The aim of this study was to assess the use of measuring left atrial pressure to complement transesophageal echocardiography and doppler imaging. Procedure efficacy is measured in the cath lab by echocardiography. However, these measurements are operator dependent and might be influenced by left ventricular function and changes in left atrial compliance. The study…
TCT 2018 | COAPT: MitraClip in Patients with Secondary Mitral Regurgitation
The prognosis of patients with heart failure and mitral regurgitation secondary to ventricular dysfunction and dilation is guarded. Percutaneous mitral valve treatment of these patients may at least improve their symptoms. This study was conducted in 78 sites in the United States and Canada, and included patients with moderate-to-severe (3+) or severe (4+) mitral regurgitation who…
TCT 2018 | REDUCE-FMR: Indirect Annuloplasty in Secondary Mitral Regurgitation
Prior studies such as the AMADEUS, TITAN or TITAN II have shown reduction of mitral valve regurgitation (MR) with the Carillon device. This sham-controlled randomized study tested the efficacy of this device in secondary mitral regurgitation. Primary end point was echocardiographic MR reduction (blind core lab) and secondary end point were hospitalization for cardiac failure,…
Mitral Valve Repair in Patients with Cardiac Failure
The mitral valve is a complex apparatus dependent on left atrium and left ventricle functionality. Dilation of these cavities might affect mitral annulus morphology and lead to valve dysfunction, generating mitral regurgitation (MR). This type of MR has been called functional, since leaflets and tendinous chordae do not present lesions themselves; instead, they malfunction ‘secondary’…
Surgical Redo Mitral Valve Replacement vs. Valve-in-Valve in Failed Bioprosthetic Valves
Despite their higher surgical risk, patients who underwent transcatheter mitral valve replacement (TMVR) presented 1-year mortality rates similar to those of patients who had redo surgical mitral valve replacement for bioprosthetic valve failure. At one month, echocardiographic findings were similar; however, at one year, patients who underwent TMVR presented a gradient increase that had no…