Preoperative Evaluation Before MitraClip^®: Present and Future Perspective

ABSTRACT 

Mitral regurgitation (MR) is the second most common heart valve disease worldwide. Currently, the management of MR is based on medical therapy (including biventricular pacing), surgery (mitral valve replacement or repair) and percutaneous therapy. However, in spite of guideline recommendations, 50% of individuals assessed in the Euro Heart Survey were not referred to surgical intervention due to comorbidities or real or perceived high risks for cardiac surgery; thus, in recent years, the focus of research has shifted to the development of percutaneous approaches to treat severe MR in order to restore valve function in a minimally invasive fashion. Among these techniques, the percutaneous mitral valve repair procedure using the MitraClip^® system (Abbott Vascular, IL, USA) is one of the most promising. Usually, patient selection for MitraClip implantation is based on careful echocardiographic assessment of valve disease; however, although definitive data are lacking, evidence is mounting for a multiparametric approach including the evaluation of the functional status of patients.

KEYWORDS :

• cardiopulmonary exercise test
• echocardiography
• MitraClip^® procedure
• mitral regurgitation
• percutaneous intervention

Financial & competing interests disclosure

FP Schmidt has received honoraria for lectures from Abbott Vascular. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

^†The current patient considerations are based on the EVEREST II study and commercial European experience to date.

The MitraClip Patient Selection Considerations document has been endorsed by the Crossroads faculty.

^†The current patient considerations are based on the EVEREST II study and commercial European experience to date.

The MitraClip Patient Selection Considerations document has been endorsed by the Crossroads faculty.