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State of the Art of the MitraClip Therapy: Who, When, and How?

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Edge-to-Edge Mitral Repair

Abstract

In the last decades, many different technological improvements have been developed and tested to treat patients affected by severe mitral valve regurgitation (MR) who are not eligible to surgery due to advanced age, comorbidities and heart dysfunction. One of these technological improvements involved the creation of the MitraClip System which mimics the surgical edge-to-edge stitch by implanting a clip via a transatrial transfemoral access under fluoroscopic and transesophageal echocardiographic guidance; this technique has emerged as the most used transcatheter approach to treat MR. Despite the high risk profile of treated patients, the MitraClip provides satisfactory results in terms of procedural safety and improvement of symptoms and quality of life. The MR reduction, however, is suboptimal compared to surgery and is likely to impair long-term outcomes of the patients, as it has been already observed in surgical experience. In prospect, the addition of a percutaneous annuloplasty could improve the overall long-term results of the procedure. Current guidelines take into consideration transcatheter mitral valve repair via MitraClip System in case of symptomatic high-risk or inoperable patients with more than 1 year expected survival after Heart-Team discussion, both in functional and degenerative MR. A careful selection of the patients from an anatomical and clinical point of view is essential to achieve efficacy and avoid futility.

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Authors and Affiliations

  1. Department of Cardiac Surgery, IRCCS San Raffaele University Hospital, Via Olgettina, 60, Milan, 20100, Italy

    Paolo Denti, Nicola Buzzatti & Giovanni La Canna

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  1. Paolo Denti
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  2. Nicola Buzzatti
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  3. Giovanni La Canna
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Correspondence to Paolo Denti .

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Editors and Affiliations

  1. Department of Cardiac Surgery, San Raffaele Hospital, Milan, Italy

    Ottavio Alfieri

  2. Department of Cardiac Surgery, San Raffaele Hospital, Milan, Italy

    Michele De Bonis

  3. Department of Cardiac Surgery, San Raffaele Hospital, Milan, Italy

    Giovanni La Canna

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Denti, P., Buzzatti, N., La Canna, G. (2015). State of the Art of the MitraClip Therapy: Who, When, and How?. In: Alfieri, O., De Bonis, M., La Canna, G. (eds) Edge-to-Edge Mitral Repair. Springer, Cham. https://doi.org/10.1007/978-3-319-19893-4_13

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  • DOI: https://doi.org/10.1007/978-3-319-19893-4_13

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19892-7

  • Online ISBN: 978-3-319-19893-4

  • eBook Packages: MedicineMedicine (R0)

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