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2016 ; 16
(3
): 270-6
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The Evolving Role of Percutaneous Mitral Valve Repair
#MMPMID27660576
Stewart MH
; Jenkins JS
Ochsner J
2016[Fal]; 16
(3
): 270-6
PMID27660576
show ga
BACKGROUND: Mitral regurgitation (MR) is the second leading cause of valvular
heart disease in the United States behind aortic stenosis. The percutaneous
repair of the mitral valve (MitraClip, Abbott, Inc.) has been approved in the
United States since 2013 as an alternative to traditional mitral valve surgery.
However, many questions are left unanswered about when to perform this procedure
and whom to perform it on. METHODS: We reviewed major published literature on the
MitraClip from 2003-2016 to help guide clinical decision-making. A PubMed search
was conducted using the phrase "mitraclip" or "percutaneous mitral valve repair"
to identify relevant articles pertaining to the clip as well as surgical valve
repair. RESULTS: The clinical trials EVEREST I and EVEREST II (Endovascular Valve
Edge-to-Edge Repair Study) demonstrated the safety and efficacy of the MitraClip
but did not prove its superiority to surgical repair in the population studied.
Numerous subsequent registries have suggested that the success of the MitraClip
varies with the patient population studied. The currently enrolling
Cardiovascular Outcomes for Assessment of the MitraClip Percutaneous Therapy for
Heart Failure Patients with Functional MR (COAPT) trial hopes to answer some of
these questions. CONCLUSION: The MitraClip is a new and exciting technology for
percutaneously treating disease processes traditionally managed with surgery. The
future of the clip and its patient population is dependent on further studies.
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