Mitral Regurgitation: An Alternative to the Knife?

In EVEREST II, percutaneous valve repair with a mechanical clip was safer but less efficacious than surgical repair or replacement.

Medical management of clinically significant mitral regurgitation (MR) relieves symptoms but does not affect disease progression, which results in left ventricular (LV) dysfunction and an annual death rate of 5%. Therefore, surgery is currently recommended for symptomatic moderate-to-severe (grade 3+) or severe (grade 4+) MR. The EVEREST I trial showed the feasibility of percutaneous double-orifice repair using a mechanical clip delivered into the left atrium by transseptal access (JW Cardiol Jan 26 2006). In EVEREST II, the investigators randomized 279 patients with grade 3+ or 4+ MR (average age, 67; 38% women) in a 2:1 ratio to either percutaneous repair, or surgical repair or replacement, of the mitral valve.

At 12 months, the rate of th…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)