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…
COAPT: Nutritional Condition Is an Important Factor in Edge-to-Edge Treatment
Heart failure is strongly associated with malnutrition or poor nutrition, which has been linked to increased mortality during follow-up. We know that mitral regurgitation causes progressive heart failure and affects nutrition. The COAPT Study has demonstrated the benefits of edge-to-edge treatment in mitral regurgitation when combined with comprehensive medical treatment and maximum tolerated doses. However,…
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…
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…
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…
TCT 2017 | INTREPID: Mitral Replacement with a Self-Expanding Device
Courtesy of the SBHCI. Intrepid is a 43-, 46-, and 50-mm nitinol self-expanding valve with bovine pericardial leaflets that is placed using a transapical delivery system with a 35-Fr access. This pilot study enrolled 50 patients with severe mitral regurgitation who were symptomatic and at a high surgical risk, or in whom surgery was contraindicated. Read…
TCT 2017 | MAVERIC: Results 6 Months After Transcatheter Mitral Valve Replacement
Courtesy of the SBHCI. This seems to be the year for transcatheter mitral valve devices, and the ARTO system tested in this study looks promising for the treatment of patients with severe mitral regurgitation who are symptomatic due to heart failure and ejection fraction <40%. The study enrolled 50 patients who underwent clinical and ecocardiographic follow-up…
MitraClip: Should We Intervene Earlier?
Courtesy of Dr. Carlos Fava. Repairing the mitral valve with Mitraclip has become an alternative for high risk or inoperable symptomatic patients, but its long term evolution has only been tested by the EVEREST II, which had not taken into account 5 year mortality outcomes. Therefore, to better study its evolution, we need to carry out different randomized studies…
Percutaneous Mitral Annuloplasty: First Results in Humans
Courtesy of Dr. Agustín Vecchia. In the last few years, new percutaneous treatment options for mitral regurgitation have emerged. Transcatheter mitral annuloplasty with various devices is a relatively simple procedure that could compress the origin of circumflex artery branches due to the different orientation of mitral corners and the coronary sinus. The following work by Park…
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