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Assessment of the MitraClip Procedure: Reassessing the Goals

  • Shyamal Asher
    Affiliations
    Departments of Anesthesiology, Rhode Island Hospital, Providence, RI

    Department of Anesthesiology, Beth Israel Deaconess Medical Center, Needham, MA
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  • Andrew Maslow
    Correspondence
    Address correspondence to Andrew Maslow, MD, Department of Anesthesia, Rhode Island Hospital, 63 Prince Street, Needham, MA 02492.
    Affiliations
    Departments of Anesthesiology, Rhode Island Hospital, Providence, RI

    Department of Anesthesiology, Beth Israel Deaconess Medical Center, Needham, MA
    Search for articles by this author
  • River Black
    Affiliations
    Departments of Anesthesiology, Rhode Island Hospital, Providence, RI

    Department of Anesthesiology, Beth Israel Deaconess Medical Center, Needham, MA
    Search for articles by this author
Published:November 04, 2022DOI:https://doi.org/10.1053/j.jvca.2022.10.023
      THE MITRACLIP (Abbott Laboratories) was first implanted in 2003, was approved in Europe in 2008, and approved by the US Food and Drug Administration in 2013. The MitraClip procedure has reduced hospitalization and mortality compared to medical therapy, with either improved or similar outcomes compared with isolated mitral valve surgery.
      • Shah MA
      • Dalak FA
      • Alsamadi F
      • et al.
      Complications following percutaneous mitral valve edge-to-edge repair using MitraClip.
      • Stone GW
      • Lindenfeld JA
      • Abraham WT
      • et al.
      Transcatheter mitral-valve repair in patients with heart failure.
      • Stone GW
      • Adams DH
      • Abraham WT
      • et al.
      Clinical trial design principles and endpoint definitions for transcatheter mitral valve repair and replacement: Part 2: Endpoint definitions a consensus document from the mitral valve academic research consortium.
      In the earlier and preliminary data, proponents of surgery highlighted less mitral regurgitation (MR) and fewer additional procedures after surgical correction of MR; however, the overall major cardiac adverse events were significantly lower (15% v 48%) for percutaneous procedures.
      • Feldman T
      • Foster E
      • Glower DD
      • et al.
      Percutaneous repair or surgery for mitral regurgitation.
      Since the initial experiences, all outcomes for MitraClip procedures have improved with greater experience.
      • Chhatriwalla AK
      • Vemulapalli S
      • Holmes DR
      • et al.
      Institutional experience with transcatheter mitral valve repair and clinical outcomes.

      Key Words

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      Linked Article

      • Right Ventricular Failure in Emergent MitraClip Therapy—A Problem Worth Investigating
        Journal of Cardiothoracic and Vascular Anesthesia
        • Preview
          The MitraClip (Abbott, Santa Clara, CA) has emerged as a safe, effective, and durable treatment for hemodynamically significant mitral regurgitation (MR) refractory to maximally tolerable guideline-directed medical therapy in nonsurgical patients.1-9 Hemodynamically, the MitraClip reduces left ventricular volumes, unloads the left atrium and pulmonary circulation, reduces right ventricular afterload (as long as iatrogenic MitraClip-induced mitral stenosis does not develop), and facilitates biventricular reverse remodeling.
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