Urgent/Emergent MitraClip Therapy in Decompensated Heart Failure — Afterload Mismatch Treatment May Improve Short and Intermediate Cardiovascular Outcomes

Published:January 14, 2022DOI:https://doi.org/10.1053/j.jvca.2022.01.015
      Mitral regurgitation (MR) is a common valvular heart pathology in the United States — prevalent in about 1.7% of the population — and is associated with considerable morbidity and mortality.1,2 Clinical symptoms develop as the regurgitant volume becomes hemodynamically significant and causes left ventricular dilation and dysfunction, left atrial hypertension, atrial arrhythmias, pulmonary vascular congestion, and right heart dysfunction. Traditionally, the treatment of MR has targeted eliminating the regurgitant blood volume with guideline directed medical therapy (GDMT), cardiac resynchronization therapy (CRT), and open surgical repair/replacement of the mitral valve.3-9 Unfortunately, a subset of MR patients fail GDMT and CRT and may also be at prohibitive risk for open mitral valve surgery. Percutaneous MR correction with transcatheter edge-to-edge repair (TEER) has emerged as a safe and effective alternative approach to MR treatment in such high-risk patients.3-6
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