Edge-to-edge treatment of the mitral valve is currently a valid alternative to surgery in cases of mitral regurgitation. Different studies have taken residual mitral regurgitation as a parameter of success, but little research has been conducted on the residual gradient once the procedure has been completed. What has been published is that a mean gradient…
Transcatheter Edge-To-Edge Repair Is Favorable for Elderly Patients at High Surgical Risk
Mitral valve prolapse is the most frequent cause of mitral valve regurgitation and is associated to hospitalization for cardiac failure and mortality. At present, the preferred treatment for operable patients is mitral valve surgical repair. Transcatheter edge to edge repair (TEER) has shown great benefit patients at high surgical risk; however, it has not been…
Is Increased Mitral Valve Gradient After MitraClip a Long-Term Prognostic Factor?
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…
MitraClip Failure: What Should We Do?
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…
New Valvular Heart Disease Guidelines with Key TAVI and Mitral Regurgitation Updates
Valvular heart disease management guidelines were updated last week by the AHA and the ACC. The last complete version had been published in 2014; therefore many of its recommendations have become obsolete before the latest evidence. The studies that made the FDA approve TAVI for low-risk patients are probably the most important incorporations. They also…
EuroPCR 2020 | CLASP: New Device for Mitral Repair with at One Year Follow Up
The CLASP looked into patients treated with the new device for transcatheter mitral repair called PASCAL and showed low complications rate, high survival rate, significant mitral regurgitation reduction and improved quality of life at one year. In July 2019 we published on our web page the 30 year outcomes of the PASCAL device () which…
Promising Outcomes of Transcatheter Mitral Valve Replacement in Complex Patients
Courtesy of Dr. Carlos Fava. The risk of repeat surgical mitral valve repair involves 6% to15% mortality at 30 days, even close to 20% in acute cases. However, mortality can rise to over 40% when it comes to a third or fourth surgical intervention. One of the solutions to this serious problem is transcatheter mitral…
Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points
After transcatheter mitral valve repair with MitraClip, the COAPT patients saw improved quality of life, better survival rate and fewer hospitalizations for cardiac failure at long term follow-up. Improved quality of life had already been presented, exactly one year ago at the ACC 2019. In that occasion, it was established that the MitraClip reduces symptoms…
Virtual ACC 2020 | Unlike in TAVR, the Number of Mitral Valve Surgeries Does Not Improve the Outcomes of Transcatheter Mitral Valve Repairs
Soon, our website will feature an interesting study showing that sites with a higher number of conventional surgical aortic valve replacements had better outcomes in transcatheter aortic valve replacement procedures. The study featured in this article was scheduled for presentation at the American College of Cardiology 2020 Scientific Session along the World Congress of Cardiology.…
Percutaneous Annuloplasty in Functional Mitral Regurgitation vs. Sham Procedure
In cases where it is difficult to demonstrate the improvement of a drug or a device in hard endpoints such as mortality, we should look for softer and easier to prove endpoints. The problem is that these soft endpoints are often subjective (such as sensation of shortness of breath or angina pectoris) and they could…
Venous Pulmonary Waveforms in MitraClip Have Prognostic Value
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…