Chapter 10
Transcatheter Repair
MitraClip for Degenerative Mitral Regurgitation
Book Editor(s):Ron Waksman,
Toby Rogers,
Ron Waksman
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
Search for more papers by this authorToby Rogers
Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
Search for more papers by this authorFirst published: 12 March 2021
Summary
Surgical mitral valve repair for degenerative mitral regurgitation (DMR) has been the standard therapy for many years. The use of MitraClip for the treatment of DMR has been well-established for prohibitive risk for surgery patients. Mitral surgery for DMR utilizes a variety of techniques including leaflet and chordal repair and annuloplasty, and transcatheter devices have recapitulated the surgical techniques. A randomized trial, EVEREST II, was performed in the United States and compared MitraClip with surgical mitral valve repair or replacement. This landmark pivotal trial was the first large randomized trial of a catheter-based device for mitral repair. One of the challenges to the MitraClip procedure is the assessment of the balance between reduced MR and the transmitral gradient caused by narrowing of the orifice.
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